A clinical comparison between DisCoVisc and 2% hydroxypropylmethylcellulose in phacoemulsification: a fellow eye study

Abstract

OBJECTIVE:This study sought to compare the effects and outcomes of two ophthalmic viscosurgical devices, 1.6% hyaluronic acid/4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose, during phacoemulsification.METHODS:This prospective, randomized clinical trial comprised 78 eyes (39 patients) that received phacoemulsification performed by the same surgeon using a standardized technique. Patients were randomly assigned to receive either 1.6% hyaluronic acid/4.0% chondroitin sulfate or 2.0% hydroxypropylmethylcellulose on the first eye. The other eye was treated later and received the other viscoelastic agent. Preoperative and postoperative examinations (5, 24 and 48 hours; 7 and 14 days; 3 and 6 months) included measurements of the total volume of the ophthalmic viscosurgical device, ultrasound and washout times to completely remove the ophthalmic viscosurgical device, intraocular pressure, central corneal thickness and best-corrected visual acuity. The corneal endothelial cell count was measured at baseline and at six months postoperatively. ClinicalTrials.gov: NCT01387620.RESULTS:There were no statistically significant differences between groups in terms of cataract density or ultrasound time. However, it took longer to remove 2.0% hydroxypropylmethylcellulose than 1.6% hyaluronic acid/4.0% chondroitin sulfate, and the amount of viscoelastic material used was greater in the 2.0% hydroxypropylmethylcellulose group. In addition, the best-corrected visual acuity was significantly better in the hyaluronic acid/chondroitin sulfate group, but this preferable outcome was only observed at 24 hours after the operation. There were no statistically significant differences between the two ophthalmic viscosurgical devices regarding the central corneal thickness or intraocular pressure measurements at any point in time. The corneal endothelial cell count was significantly higher in the hyaluronic acid/chondroitin sulfate group.CONCLUSION:The ophthalmic viscosurgical device consisting of 1.6% hyaluronic acid/4.0% chondroitin sulfate was more efficient during phacoemulsification and was easier to remove after IOL implantation than 2.0% hydroxypropylmethylcellulose. In addition, the corneal endothelial cell count was significantly higher following the use of hyaluronic acid/chondroitin sulfate than with hydroxypropylmethylcellulose, which promoted an improved level of corneal endothelium protection.

Safety of Polyacrylamide 1.5% Left in Anterior Chamber in Combined Phacoemulsification and Pars Plana Vitrectomy Surgery

“…measurements with other types of OVDs. Espindola et al 16 performed to compare the safety and efficacy of 1.6% hyaluronic acid/ 4.0% chondroitin sulfate and 2.0% hydroxypropylmethylcellulose (HPMC) and found no significant difference in postoperative CCT measurements in both groups. Davis et al 18 also compared 1.6% sodium hyaluronate, 4.0% chondroitin sulfate/3.0% sodium hyaluronate and 2.0% HPMC, and found no significant difference in CCT measurements.…”

Safety of Hydroimplantation: A Foldable Intraocular Lens Implantation without the Use of An Ophthalmic Viscosurgical Device

“…On the other hand, an OVD remaining in the eye may cause mechanical obstruction of the trabecular meshwork and is a major reason for early postoperative increases in IOP (20). A number of studies compare the effects of different types of OVDs on postoperative increases in IOP (1,2,17,(21)(22)(23)(24)(25). Rainer et al (2) described the IOP spike as 30 mm Hg or higher 2 hours after surgery in 70% of the eyes in the group of patients where chondroitin sulfate 4%/sodium hyaluronate 3% (Viscoat) was used.…”

Heterologous production of chondroitin

“…Depending on their application, different systems have been implemented for the administration of chondroitin and its derivatives, including oral administration as food additives, in pharmaceutical preparations, nutraceuticals or veterinary supplements [ 74 , 75 , 76 , 77 ]; incorporation in intra-articular or intravenous injectables [78] ; integration in skin dermatology/cosmeceutical and ophthalmic products [ 79 , 80 , 81 ]; as part of medical devices [ 82 , 83 , 84 , 85 ]; or as biomaterials for regenerative medicine [ 9 , 86 ].…”

“…For interstitial cystitis, the intravesical treatment with CS achieved improved efficiency in pain reduction and nocturia and had superior tolerability over DMSO, a standard approved therapy [84] . CS is also found in solutions for preserving corneas [102] , or in injectable devices to protect the eye during cataract surgery (phacoemulsification) [ 82 , 83 ]. The ophthalmic viscosurgical devices containing HA and CS (DisCoVisc, Viscoat and Duovisc) showed greater efficiency during phacoemulsification, and improved protection of corneal endothelium, compared to hydroxypropylmethylcellulose [82] and to HA and lidocaine hydrochloride (Visthesia) injectables [83] .…”