Corneal edema and intraocular pressure after cataract surgery

PURPOSE: To compare the protective effect of Healon5 (sodium hyaluronate 2.3%) and Amvisc Plus (sodium hyaluronate 1.6%) against corneal edema and their association with postoperative intraocular pressure (IOP) spikes in patients having phacoemulsification and intraocular lens (IOL) implantation. SETTING: Ophthalmology department of a general hospital. METHODS: One hundred forty patients were randomly assigned to have surgery with Healon5 (n = 70) or Amvisc Plus (n = 70). One eye of each patient was analyzed. Data collected preoperatively included best corrected visual acuity (BCVA) and IOP. Central ultrasonic pachymetry was performed in all patients. The same ophthalmologist performed all surgeries. The IOP and central corneal thickness (CCT) were measured 1 and 4 days and 1 month after surgery. The BCVA was also assessed at 1 month. RESULTS: There were no significant preoperative differences between the Healon5 and Amvisc Plus groups in sex, age, ocular pathology, BCVA, IOP, or CCT. Intraoperative variables were similar between groups, but it took significantly longer to remove the Healon5. Postoperatively, there were no differences between groups in the evolution of CCT or of IOP. Intraocular pressure spikes over 30 mm Hg were detected at 1 day in 7 patients in the Healon5 group and 2 patients in the Amvisc Plus group (10.0% versus 2.9%; P = .165). CONCLUSIONS: Both OVDs were beneficial in a wide range of cataract patients. However, the results suggest a tendency toward a higher complication rate with Healon5.