Comparative evaluation of the results of phacoemulsification using domestic and foreign viscoelastics

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Abstract

BACKGROUND: Phacoemulsification, being the safest technique, is the “golden standard” of cataract surgery worldwide. However, as any surgery, it is accompanied by inevitable damage to intraocular structures. The most prevalent among them is the loss of corneal endothelial cells. In order to prevent these complications, various viscoelastics with particular features and characteristics are widely used.

AIM: To compare the anatomical and functional state of ocular structures after standard phacoemulsification with monofocal posterior chamber intraocular lens (IOL) implantation using domestic (Kogevisc and Adgevisc) and foreign (Viscoat and Amvisc Plus) viscoelastics.

MATERIALS AND METHODS: 60 cataract patients (60 eyes) were included in the clinical study, which were divided into two equal groups. In the first group (30 patients, 30 eyes), Adgevisc and Kogevisc (Solofarm, Russia) were used during the procedure. The mean age of the patients was 66 ± 11 years. In the second group (30 patients, 30 eyes), Viscoat (Alcon) and Amvisc Plus (Bausch&Lomb) were used. The mean age of the patients was 69.03 ± 10.44 years. All patients underwent phacoemulsification with the implantation of the AcrySof IOL (model SA60AT, Alcon) according to the standard technique. Visual acuity, IOP level, CCT, corneal endothelial cell density were assessed. All studies were performed before surgery, the next day, 7 days and 1 month after surgery.

RESULTS: In patients of the second group, on the 1st (p ≤ 0.05) and 7th day (p ≤ 0.01) after surgery, a statistically significant increase in IOP was revealed compared to the first group. The central cornea thickness in the early postoperative period was higher in patients of the second group, however, it was not statistically significant. The loss of corneal endothelial cells 1 month after surgery was 8.5 ± 7.0% (p ≤ 0.01) in the first group and 6.6 ± 6.4% in the second group (p ≤ 0.01). The mean value of endothelial cell loss in patients of the first group was higher, however, it was not statistically significant. The best corrected visual acuity in both groups at all stages of follow-up after surgery (days 1, 7 and 30) was comparable, there was no significant difference between the groups.

CONCLUSIONS: The clinical efficacy of domestic adhesive and cohesive viscoelastics Adgevisc and Kogevisc (Solofarm, Russia) in phacoemulsification using the soft-shell technique is comparable to the foreign analogues Viscoat (Alcon) and Amvisc Plus (Bausch & Lomb), which is confirmed by the absence of statistically significant differences in the studied parameters of the postoperative state of ocular structures and explained by their similar composition, molecular weight and viscosity.

About the authors

Georgiy Z. Dzhaliashvili

I.P. Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: zurabych@yandex.ru

Ophthalmologist, Professor Yu.S. Astakhov Ophthalmology Department with Clinic

Russian Federation, Saint Petersburg

Elmaz E. Farikova

I.P. Pavlov First Saint Petersburg State Medical University

Email: Elmazfarikova@yandex.ru

Ophthalmologist, Professor Yu.S. Astakhov Ophthalmology Department with Clinic

Russian Federation, Saint Petersburg

References

  1. Borkenstein AF, Borkenstein EM, Malyugin B. Ophthalmic viscosurgical devices (OVDs) in challenging cases: a review. Ophthalmol Ther. 2021;10(4):831–843. doi: 10.1007/s40123-021-00403-9
  2. Meduri A, Urso M, Signorino GA, et al. Cataract surgery on post radial keratotomy patients. Int J Ophthalmol. 2017;10(7):1168–1170. doi: 10.18240/ijo.2017.07.23
  3. Kretz FTA, Limberger I-J, Auffarth GU. Corneal endothelial cell coating during phacoemulsification using a new dispersive hyaluronic acid ophthalmic viscosurgical device. J Cataract Refract Surg. 2014;40(11):1879–1884. doi: 10.1016/j.jcrs.2014.04.025
  4. Auffarth GU, Auerbach FN, Rabsilber T, et al. Comparison of the performance and safety of 2 ophthalmic viscosurgical devices in cataract surgery. J Cataract Refract Surg. 2017;43(1):87–94. doi: 10.1016/j.jcrs.2016.10.025
  5. Arshinoff SA. Dispersive-cohesive viscoelastic soft shell technique. J Cataract Refract Surg. 1999;25(2):167–173. doi: 10.1016/S0886-3350(99)80121-7
  6. Kunishige T, Takahashi H. Effects of combinations of ophthalmic viscosurgical devices and suction flow rates on the corneal endothelial cell damage incurred during phacoemulsification. J Ophthalmol. 2020;2020:2159363. doi: 10.1155/2020/2159363
  7. Malvankar-Mehta MS, Fu A, Subramanian Y, Hutnik C. Impact of ophthalmic viscosurgical devices in cataract surgery. J Ophthalmol. 2020;2020:7801093. doi: 10.1155/2020/7801093
  8. Watanabe I, Hoshi H, Sato M, Suzuki K. Rheological and adhesive properties to identify cohesive and dispersive ophthalmic viscosurgical devices. Chem Pharm Bull (Tokyo). 2019;67(3):277–283. doi: 10.1248/cpb.c18-00890
  9. Suzuki H, Igarashi T, Shiwa T, Takahashi H. Efficacy of Ophthalmic viscosurgical devices in preventing temperature rise at the corneal endothelium during phacoemulsification. Curr Eye Res. 2016;41(12):1548–1552. doi: 10.3109/02713683.2015.1136420
  10. Loskoutov IA, Korneeva AV. The influence of new ophthalmic viscoelastic devices on the level of intraocular pressure after phacoemulsification. National Journal glaucoma. 2020;19(2):31–38. (In Russ.) doi: 10.25700/NJG.2020.02.04
  11. Ramezani F, Nazarian M, Rezaei L. Intraocular pressure changes after phacoemulsification in pseudoexfoliation versus healthy eyes. BMC Ophthalmol. 2021;21(1):198. doi: 10.1186/s12886-021-01970-y
  12. Carolan JA, Liu L, Alexeeff SE, et al. Intraocular pressure reduction after phacoemulsification: a matched cohort study. Ophthalmol Glaucoma. 2021;4(3):277–285. doi: 10.1016/j.ogla.2020.10.002
  13. Kiddee W, Tanjana A. Variations of intraocular pressure measured by Goldmann applanation tonometer, Tono-Pen, iCare rebound tonometer, and Pascal dynamic contour tonometer in patients with corneal edema after phacoemulsification. J Glaucoma. 2021;30(4):317–324. doi: 10.1097/IJG.0000000000001725
  14. Potemkin VV, Varganova TS, Ageeva EV. The impact of phacoemulsification on corneal endothelial cells in patients with pseudoexfoliation syndrome. Russian Ophthalmological Journal. 2019;12(1):50–55. (In Russ.) doi: 10.21516/2072-0076-2019-12-1-50-55
  15. Hwang HB, Lyu B, Yim HB, Lee NY. Endothelial cell loss after phacoemulsification according to different anterior chamber depths. J Ophtalmol. 2015;2015:210716. doi: 10.1155/2015/210716
  16. Shukhayev SV. Comparative estimation of endothelial cell loss in the zone of the corneal tunnel after microcoaxial and bimanual phacoemulsification. Vestnik of the Orenburg State University. 2013;(4):315–317. (In Russ.)
  17. Perone JM, Boiche M, Lhuillier L, et al. Correlation between postoperative central corneal thickness and endothelial damage after cataract surgery by phacoemulsification. Cornea. 2018;37(5): 587–590. doi: 10.1097/ICO.0000000000001502
  18. Onakpoya OH, Adeoye AO, Adegbehingbe BO, et al. Intraocular pressure variation after conventional extracapsular cataract extraction, manual small incision cataract surgery and phacoemulsification in an indigenous black population. Pan Afr Med J. 2020;36:119. doi: 10.11604/pamj.2020.36.119.16942
  19. Ungricht EL, Culp C, Qu P, et al. Effect of phacoemulsification fluid flow on the corneal endothelium: experimental study in rabbit eyes. J Cataract Refract Surg. 2022;48(4):481–486. doi: 10.1097/j.jcrs.0000000000000768
  20. Vasavada V, Raj SM, Praveen MR, et al. Real-time dynamic intraocular pressure fluctuations during microcoaxial phacoemulsification using different aspiration flow rates and their impact on early postoperative outcomes: a randomized clinical trial. J Refract Surg. 2014;30(8):534–540. doi: 10.3928/1081597X-20140711-06
  21. Reuschel A, Bogatsch H, Barth T, Wiedemann R. Comparison of endothelial changes and power settings between torsional and longitudinal phacoemulsification. J Cataract Refract Surg. 2010;36(11):1855–1861. doi: 10.1016/j.jcrs.2010.06.060
  22. Huseyin M, Fatma BE, Emin K, Sami LS. Corneal endothelial damage in phacoemulsification using an anterior chamber maintainer compared with using an ophthalmic viscosurgical device. J Cataract Refract Surg. 2021;47(5):612–617. doi: 10.1097/j.jcrs.0000000000000493
  23. Sharma N, Singhal D, Nair SP, et al. Corneal edema after phacoemulsification. Indian J Ophthalmol. 2017;65(12):1381–1389. doi: 10.4103/ijo.IJO_871_17
  24. Lahagu EA, Fachiroh J, Anugrah AS, et al. Changes of lactate dehydrogenase in corneal edema after cataract surgery treated with trans-corneal oxygenation therapy. Int J Ophthalmol. 2020;13(7):1148–1151. doi: 10.18240/ijo.2020.07.19
  25. TU 32.50.50-011-64260974-2018. Viskoprotektor Kogevisk®. Instruktsiya po primeneniyu meditsinskogo izdeliya. (In Russ.)
  26. Storr-Paulsen A, Norregaard JC, Ahmed S, et al. Endothelial cell damage after cataract surgery: divide-and-conquer versus phaco-chop technique. Journal of Cataract and Refractive Surgery. 2008;34(6):996–1000. doi: 10.1016/j.jcrs.2008.02.013

Supplementary files

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2. Fig. 1. Comparison of IOP levels between groups at different follow-up periods

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3. Fig. 2. Comparison of the thickness of the central zone of the cornea between groups at different follow-up periods

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4. Fig. 3. Comparison of corneal endothelial cell loss between groups at different follow-up periods

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5. Fig. 4. Comparison of best corrected visual acuity between groups at different follow-up periods

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Copyright (c) 2022 Dzhaliashvili G.Z., Farikova E.E.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


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