A Clinical Comparison of Safety and Efficacy in Phacoemulsification with versus without Ophthalmic Viscoelastic Device

Kuğu, Süleyman; Erdoğan, Gürkan; Sevim, Mehmet Şahin; Özertürk, Yusuf

doi:10.3109/08820538.2013.833261

Cited by 13 publications

(10 citation statements)

References 21 publications

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“…or longer UST (uneven/ patchy endothelial damage disallowing ECD analysis; unpublished data). We think that low ECL rates in most studies could be the reason for nonsignificant results in many clinical studies (Praveen et al 2009;Vasavada et al 2010;Kugu et al 2015;Taskin & Aslan 2018).…”

Section: Discussionmentioning

confidence: 99%

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

Kunzmann

Wenzel

Bartz‐Schmidt

et al. 2019

Acta Ophthalmologica

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Purpose The purpose of this study was to establish a standardized in vitro phacoemulsification damage model for future investigations of the effects of phacoemulsification, surgical devices, protective ophthalmic viscoelastic devices (OVDs), irrigation solutions and other aspects related to cataract phacoemulsification surgery on the corneal endothelium using porcine eyes. Methods Thirty‐four porcine eyes were randomly assigned to three groups (phacoemulsification (n = 13), irrigation (n = 9), control (n = 12)). A total of 5 min of ultrasound energy with intermittent irrigation/aspiration was applied in the eyes of the phacoemulsification group. The eyes of the irrigation group received the identical treatment, but without the application of ultrasound energy. The control group was left untreated. All eyes were then prepared to split corneal buttons followed by 15 days of cultivation. Endothelial cell density (ECD) was assessed blinded on day 15. Results Endothelial cell density declined significantly more until day 15 in the phacoemulsification group (2567 ± 317/267 cells/mm² (median ± 25%/75%‐quartiles), −32.5 ± 7.0/6.4%) compared to the irrigation (3450 ± 350/383 cells/mm², −11.8 ± 5.3/2.6%; p < 0.001) and the control group (3650 ± 288/258 cells/mm², −10.2 ± 3.2/4.6%; p < 0.001). Conclusion The phacoemulsification damage model presented in this study is sensitive to phacoemulsification energy and may reliably be used to investigate various factors involved in phacoemulsification with regard to their influence on corneal endothelial cells. This method is able to replace animal experiments or in vitro cell culture experiments that often do not translate well to the in vivo situation in humans.

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Section: Discussionmentioning

confidence: 99%

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

Kunzmann

Wenzel

Bartz‐Schmidt

et al. 2019

Acta Ophthalmologica

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“…21,22 Although using OVDs is often preferred at some stages, studies have also shown that phacoemulsification surgery with IOL implantation applied without OVDs is safe and cost-effective. 23 For instance, Sallet et al compared the operating times of 100 phacoemulsification surgeries performed with and without an OVD and observed that operations without the OVD took 1.6 min less on average. 9 In a non-randomized, prospective study, Schulze et al compared the results of using an OVD versus BSS in IOL implantation during phacoemulsification surgery, among which the mean operating time was 1 min less when BSS was used.…”

Section: Discussionmentioning

confidence: 99%

“…12 In other work, Kugu et al compared the results of phacoemulsification surgery performed with and without an OVD, and at 3 months postoperation, no significant difference had arisen in corneal endothelial loss between the groups. 23 In Taskin et al's study, the results of phacoemulsification surgery applied with and without an OVD were compared, and at 3 months after surgery, corneal endothelial loss was similar in both the BSS and OVD groups. 27 Bardaloi et al also compared pure phacoemulsification (i.e.…”

Section: Discussionmentioning

confidence: 99%

The safety and efficacy of phacoemulsification surgery in uncomplicated cataracts with and without an ophthalmic-viscosurgical-device

Akmaz

Kılıç

Duru³

2022

European Journal of Ophthalmology

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Purpose To compare and evaluate the results of phacoemulsification surgery involving and not involving an ophthalmic-viscosurgical-device (OVD). Methods A prospective, randomized controlled trial included 60 eyes of 60 patients scheduled to receive phacoemulsification surgery. In order of presentation, patients were randomized into two groups to undergo different surgical techniques: the OVD-free group ( n = 30) and the OVD group ( n = 30). Each patient’s operating time, total ultrasonography (U/S) time, cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution (BSS) aspirated were recorded. At 1 day, 1 week, and 1 and 3 months postoperation, measurements of endothelial cell density (ECD) and intraocular pressure (IOP), were taken and compared between the groups. Results Total U/S time ( p = .567) and CDE ( p = .168) were similar between the groups. In the OVD group, operating time ( p = .011), aspiration time ( p < .001), and volume of BSS aspirated ( p < .001) were greater than in the OVD-free group. The change in ECD between the groups was not statistically significant at all visits ( p = .433, p = .147, p = .379, p = .534; respectively). Although IOP increased in the OVD group at 1 day postoperation ( p = .001), no difference emerged between the groups at 3 months postoperation ( p = .121). Conclusion Phacoemulsification surgery without an OVD took less time than with the OVD and caused no significant loss in ECD. Surgeons concerned about elevated IOP following cataract surgery should apply the OVD-free method.

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“… 2 3 25 26 Furthermore, there are many different factors which could affect ECD during phacoemulsification cataract surgery, such as the characteristics of the phacoemulsification device, the total surgery time and the energy delivery, phaco-mode, and last but not least, the surgeon's experience. 3 4 5 6 7 8 A prospective study performed by Kugu et al ., 27 comparing two groups of patients operated with and without VS, was published in 2015. They could not determine a protective effect of 1.0% sodium hyaluronate over BSS on ECD loss during phacoemulsification.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that endothelial corneal cells decrease after cataract surgery. Nevertheless, there is a great variability in literature regarding the percentage of loss after phacoemulsification, ranging from 3.1% 27 to 18.46%. 28 In this study, ECD decreased 7.11% in the first 6 months following surgery and 2.51% more in the second postoperative semester, completing a total decrease of 9.62% 1 year after surgery.…”

Section: Discussionmentioning

confidence: 99%

Corneal Endothelial Health after Phacoemulsification Cataract Surgery Without Viscoelastic Substance

Roberto¹

2021

Journal of Current Ophthalmology

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Purpose: To evaluate corneal endothelial health after cataract surgery without viscoelastic substance (VS). Methods: A prospective, non-randomized, case-series study was developed, and phacoemulsification cataract surgery without VS was performed on 1324 eyes between September 2015 and September 2018. As main outcomes, mean endothelial cell density (ECD) and mean central corneal thickness (CCT) were assessed before surgery and then 6 and 12 months after surgery. Data are summarized as mean, standard deviation (SD), and 95% confidence intervals (CI). Results: A total of 1324 eyes were operated, and 31 were excluded by intraoperative complications. The mean ECD baseline was 2506 cells/mm2 (SD = 215, CI = 2494–2518); 6 months after surgery, it was 2328 cells/mm2 (SD = 213, CI = 2316–2340); and 1 year after surgery, it was 2265 cells/mm2 (SD = 214, CI = 2253–2277). In terms of percentage differences, the mean ECD decrease was 9.4% after 1 year. The mean preoperative CCT was 531.6 μm (SD = 34.8, CI = 529.7–533.5); 6 months after surgery, it was 537.7 μm (SD = 38.2, CI = 535.6–539.8); and 1 year after surgery, it was 537.9 μm (SD = 37.9, CI = 535.8–540.0). The mean CCT increased 1.2% 1 year after surgery. Conclusions: Phacoemulsification cataract surgery can be completely performed without VS, with very low intraoperative complications. The postoperative ECD and CCT changes occurred primarily during the first 6 months, and the changes decreased during the second semester.

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A Clinical Comparison of Safety and Efficacy in Phacoemulsification with versus without Ophthalmic Viscoelastic Device

Cited by 13 publications

References 21 publications

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

Effects of ultrasound energy on the porcine corneal endothelium – Establishment of a phacoemulsification damage model

The safety and efficacy of phacoemulsification surgery in uncomplicated cataracts with and without an ophthalmic-viscosurgical-device

Corneal Endothelial Health after Phacoemulsification Cataract Surgery Without Viscoelastic Substance

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