Tripolymeric Corneal Coating Gel Versus Balanced Salt Solution Irrigation During Cataract Surgery: A Retrospective Analysis

Abstract

Purpose:To compare the protective properties and ease of manipulation during cataract surgery of corneal coating with a gel (eyeDRO; AL.CHI.MI.A. S.R.L, Italy) and corneal irrigation with balanced salt solution (BSS).Methods:We analyzed the data of 51 patients receiving either eyeDRO or BSS during routine cataract surgery performed within a 20-day period in 2016. The selected parameters were intraoperative clarity and ease of manipulation; postoperative epithelial integrity; and patient discomfort.Results:Compared with BSS irrigation, eyeDRO coating significantly increased intraoperative clarity and ease of manipulation (P < 0.01). Single application was required in eyeDRO-treated eyes, whereas BSS was applied 5.3 ± 0.4 times on average (P < 0.01). Two hours postoperatively, a normal epithelium was observed in 90.0% and 60.0% of eyeDRO-coated and BSS-irrigated eyes, respectively; punctate epithelial damage was observed in 9.7% and 40.0% (P < 0.05) of eyeDRO-coated and BSS-irrigated eyes, respectively; eye irritation and foreign body sensation were experienced by 13.0% and 37.0% of eyeDRO-treated patients and by 65.0% and 100% of BSS-treated patients, respectively (P < 0.01). Twenty-four hours postoperatively, 80.0% of BSS-treated patients versus 19.0% of eyeDRO-treated patients still experienced foreign body sensation (P < 0.01).Conclusions:EyeDRO coating was shown to be a safer and more effective option than BSS irrigation in cataract surgery because single application provided optimal hydration and intraoperative clarity during the entire surgery, better preserved the corneal epithelium, and offered postoperative comfort to the patient.

Evaluation of the Protective Effect of an Ophthalmic Viscosurgical Device on the Ocular Surface in Dry Eye Patients during Cataract Surgery

“…A previous study reported that corneal erosion occurred in 60% of the eyes with an OVD applied to the ocular surface during surgery but in 90% of control eyes at 2 hours after surgery. At postoperative 2 and 24 hours, the study group showed significantly improved foreign body sensation [17]. In previous studies, some indicators of dry eye syndrome showed improvement in a short time-period of 2 to 3 days after surgery in the group with OVD applied to the ocular surface.…”

“…An ophthalmic viscosurgical device (OVD) used to maintain anterior chamber space and prevent damage to intraocular tissue during cataract surgery is excellent for protection of corneal endothelial cells [16]. Reports have indicated that OVD applied to the ocular surface during cataract surgery results in less ocular surface damage 2 hours and 24 hours after operation than balanced salt solution (BSS) irrigation on the surface [17]. Therefore, an OVD thinly coated on the corneal surface during cataract surgery is expected to greatly reduce corneal epithelial damage from continuous intraoperative perfusion of the ocular surface without interfering with the visual field.…”