To Compare The Effect Of Cohesive And Dispersive Viscoelastic Substances In Protecting The Corneal Endothelium During In-The-Bag Phacoemulsification With Implantation Of A Foldable Lens
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
Purpose: To compare the effect of cohesive and dispersive viscoelastic substances in protecting the corneal endothelium during in-the-bag phacoemulsification with implantation of a foldable lens. These effects were measured in terms of: endothelial cell count, Hexagonality frequency , The central corneal thickness. Design: Hospital based randomized interventional study Method: Study was conducted on 60 patients (30 patients in group A and 30 patients in group B) who underwent phacoemulsification with IOL implantation. Group A- Patients who underwent phacoemulsification and IOL implantation using cohesive viscoelastic. (30 eyes of 30 patients) ,Group B- Patients who underwent phacoemulsification and IOL implantation using dispersive viscoelastic. (30 eyes of 30 patients). These effects were measured in terms of: endothelial cell count, Hexagonality frequency , The central corneal thickness Result: We assessed the endothelial cell count, post-operatively at intervals of 1 month and 3 months and noted that, In Group A, the mean endothelial cell count dropped to 2135.97 ± 222.6/mm2 at 1 month and 2077 ± 228/mm2 at 3 months.(P<0.001) In Group B, the mean endothelial cell count dropped to 2393.17±279.75/mm2 at 1 month and 2332 ± 281.4/mm2 at 3 months.(P<0.001) still the mean endothelial cell loss was significantly higher in group A as compared to group B at each follow up. (P<0.001) Postoperatively, the mean CCT in group A increased to 528.9 ± 8.97 microns at 1 month and then reduced to 515 ± 11 microns at 3 months postoperatively. Similarly, in group B the mean CCT increased to 517.87 ± 9.44 microns at 1 month and then reduced to 511.3 ± 9.05 at 3 months postoperatively The difference in the mean CCT between the groups was not significant preoperatively as well as at 3 months postoperatively. (P=0.12) Conclusion: At the end of 3 months we found that the mean endothelial cell loss was more in group A than group B suggesting that the dispersive viscoelastics have a role in protecting the corneal endothelium during cataract surgery in comparison to cohesive viscoelastics. Though the mean central corneal thickness and hexagonality did not alter much and the values shift towards the preoperative status at the end of 3 months, and the difference was not statistically significant at the end of 3 months. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any products discussed in this article.
Authors and Affiliations
Dr. Manisha kalher, Dr Kishor Kumar M. S
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