Back to Journals » Clinical Ophthalmology » Volume 9

Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation

Authors Schulze S, Bertelmann T, Manojlovic I, Bodanowitz S, Irle S, Sekundo W

Received 17 June 2015

Accepted for publication 1 September 2015

Published 6 November 2015 Volume 2015:9 Pages 2073—2080

DOI https://doi.org/10.2147/OPTH.S90628

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Yang Liu

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Stephan D Schulze,1 Thomas Bertelmann,1 Irena Manojlovic,2 Stefan Bodanowitz,2 Sebastian Irle,3 Walter Sekundo1

1Department of Ophthalmology, Philipps University of Marburg, Marburg, 2Private Practice and Ambulatory Surgical Center, Bremen, 3Freelance Statistician, Friedberg, Germany

Purpose: To evaluate whether the use of balanced salt solution (BSS) or an ophthalmic viscoelastic device (OVD) during hydrophilic acrylic intraocular lens (IOL) implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications.
Methods: Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus® or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy) were recorded.
Results: Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD) and endothelium cell size were 2,506±310 cells/mm2/2,433±261 cells/mm2 and 406±47 µm2/416±50 µm2 (P=0.107/P=0.09). After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001) without significant differences between both groups (each P>0.05). Irrigation–aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds) and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes) were significantly longer in the OVD Z-Celcoat group (each P<0.001). No complications or serious side effects occurred.
Conclusion: Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates.

Keywords: phacoemulsification, ophthalmic viscoelastic device, endothelial cell density, IOL

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]