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Corneal endothelial cell loss and intraocular pressure following phacoemulsification using a new viscous-cohesive ophthalmic viscosurgical device

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Abstract

Purpose

To compare results of two ophthalmic viscosurgical devices (OVDs)—Viscoat (a dispersive OVD, Alcon) and FR-Pro (a viscous-cohesive OVD, Rayner), in phacoemulsification surgery.

Methods

A prospective randomized controlled study. Patients undergoing phacoemulsification were randomly assigned to receive one of the two OVDs. Exclusion criteria were age under 40, preoperative endothelial cell count (ECC) below 1,500 cells/mm2 and an eventful surgery.

The primary outcome was change in ECC from baseline to postoperative month one and month three. Secondary outcomes were the difference between ECC at postoperative month one and month three, changes in IOP and occurrence of an IOP spike ≥ 30 mmHg after surgery.

Results

The study included 84 eyes—43 in the Viscoat group and 41 in the FR-Pro group. Mean cell density loss at month one and month three was 17.0 and 19.2%, respectively, for the Viscoat group and 18.4 and 18.8%, respectively, for the FR-Pro group, with no statistically significant difference between the groups (p = 0.772 and p = 0.671, respectively). The mean ECC difference between the month one and month three visits was 50.5 cells/mm2 and was not statistically significant (p = 0.285). One eye in each group had an IOP spike ≥ 30 mmHg, both normalized by postoperative week one.

Conclusions

Viscoat and FR-Pro have comparable results following phacoemulsification surgery, suggesting that while FR-Pro is not a dispersive OVD, its endothelial cell protection may be comparable to one, perhaps due to the addition of sorbitol. Furthermore, a one-month follow-up of ECC seems sufficient in such trials.

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Funding

The ophthalmic viscosurgical device FR-Pro was provided by Rayner. No author has a financial or proprietary interest in any material or method mentioned.

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Authors and Affiliations

  1. Department of Ophthalmology, Samson Assuta Ashdod University Hospital, Ha-Refu’a St 7, 7747629, Ashdod, Israel

    Keren Wood, Yuval Pessach, Natalya Kovalyuk, Michal Lifshitz, Halit Winter & Joseph Pikkel

Authors
  1. Keren Wood
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  2. Yuval Pessach
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  3. Natalya Kovalyuk
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  4. Michal Lifshitz
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  5. Halit Winter
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  6. Joseph Pikkel
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KW. The first draft of the manuscript was written by KW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Keren Wood.

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The authors have no conflict of interest to declare.

Ethics approval

The study's protocol was reviewed and approved by the institutional review board, and it followed the tenets of the Declaration of Helsinki.

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Written informed consent was obtained from all individual participants included in the study.

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Wood, K., Pessach, Y., Kovalyuk, N. et al. Corneal endothelial cell loss and intraocular pressure following phacoemulsification using a new viscous-cohesive ophthalmic viscosurgical device. Int Ophthalmol 44, 10 (2024). https://doi.org/10.1007/s10792-024-02997-y

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  • DOI: https://doi.org/10.1007/s10792-024-02997-y

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