The protective effect of ophthalmic viscoelastic devices on endothelial cell loss during cataract surgery: a meta-analysis using mixed treatment comparisons

Abstract

Viscoadaptives may be superior to the other OVDs, but absolute differences in loss in endothelial cell density are <100 cells/mm(2).

Trends in the Indications for Corneal Graft Surgery in the United Kingdom

“…It seems likely that the substantial increase in the rate of patients undergoing cataract surgery in the United Kingdom 17 may be influenced by ongoing im-provements in phacoemulsification technology and endothelial protection. 3,4,18,19 However, it will be important to continue studying trends in the numbers of patients requiring surgery for FED and PBK during the next decade because this will have implications for the numbers of EK and PK grafts required in future years for transplantation.…”

A Clinical Comparison of Safety and Efficacy in Phacoemulsification with versus without Ophthalmic Viscoelastic Device

“…3,9 However, the number of studies comparing their superiority over each other is limited. 18 Preserving and maintaining the anterior chamber during cataract surgery is mandatory, particularly for the protection of CEC. The mini-nuc method developed by Blumenthal 19,20 provides this by anterior chamber maintainer (ACM) under irrigation fluid.…”

A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector during Cataract Surgery

“…A meta-analysis evaluating the protective effect of OVDs on endothelial cell density up until 2007 concluded that viscoadaptive OVDs were the best option, followed by the “soft-shell” technique. However, the absolute differences in the endothelial cell loss between the various OVDs at 3 months after surgery were small (<100 cells/mm 2 ) [9]. The newer viscodispersive OVDs may offer improved endothelium protection, with lesser endothelial cell loss reported at 3 months postphacoemulsification compared to viscoadaptive OVDs (1.8% ± 8.7% versus 3.8% ± 8.3%, p = 0.0358).…”

“…The current techniques used to preserve the endothelium during cataract surgery include more effective ultrasound via a torsional delivery process [7, 8], dispersive ophthalmic viscoelastic devices (OVDs) [9–11], and the use of the “soft-shell” technique consisting of a dual layer of viscoelastics: a dispersive viscoelastic to coat the corneal endothelium and a cohesive viscoelastic to maintain the anterior chamber. There are no mechanical devices yet.…”