INTRAOCULAR PRESSURE AFTER PHACOEMULSIFICATION USING HYDROXYPROPYL METHYLCELLULOSE AND SODIUM HYALURONATE AS VISCOELASTICS
AbstractBackground: Phacoemulsification and intraocular lens (IOL) implantation has resulted in earlyvisual rehabilitation, increased wound stability and improved refractive results. Viscoelasticsubstances (VES) are important adjuncts in this type of surgery. Use of VES inphacoemulsification can be associated with adverse effects, the most common and potentiallydangerous of which is the transient rise in intraocular pressure (IOP) in post-operative period. Toevaluate the effects of viscoelastic substances on post-operative IOP after phacoemuls ificationwith implantation of intraocular lens, a cross-sectional comparative, prospective study wasconducted in the department of Ophthalmology, Combined Military Hospital, Peshawar, Pakistan,from October 2003 to March 2004. Methods: One hundred patients were randomized into twogroups of 50 each. Phacoemulsification with implantation of intraocular lens was performed in allthe patients. 2% Hydroxypropyl Methylcellulose (HPMC) was used in one group and 1% SodiumHyaluronate (NaHa) was used in the other group. IOP was measured pre-operatively as well as 24hours and 7 days post-operatively. Results: There was no significant difference in the preoperative intraocular pressure between the two groups (p=0.483). Twenty four hours after surgery,the mean IOP increased by 2.84±SD 2.12 mm Hg in 2% Hydroxypropyl Methylcellulose groupand 4.54±2.07 mm Hg in 1% Sodium Hyaluronate group. The increase was significantly higher in1% Sodium Hyaluronate group as compared to 2% Hydroxypropyl Methylcellulose group(p=0.003). Seven days after surgery the mean intraocular pressure returned to near pre-operativelevels in both the groups. Conclusion: Sodium Hyaluronate causes significantly higher increasein intraocular pressure in early post-operative period after cataract surgery inspite of maximumaspiration of viscoelastic substance from the eye following phacoemulsification surgery.Key Words: Intraocular pressure, Methylcellulose, Sodium Hyaluronate, Phacoemulsification,Viscoelastic substance.
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