Abstract
In a randomised trial the endothelial protective agent used during extracapsular cataract extraction and intraocular lens insertion was air in 19 eyes (group 1), methylcellulose in 25 eyes (group 2) and sodium hyaluronate in 22 (group 3). The cell population densities of each eye were estimated immediately before and three months after the operations to determine the degree of cell loss. Eyes showing mechanical (touch) damage on the second postoperative day were eliminated. The numbers of eyes in each group which showed a statistically significant cell loss were compared, and the mean cell losses in each group were tested for significant differences. It appears that air actually damages the endothelium while methylcellulose and Na-hyaluronate are not harmful, and afford a high, essentially equal degree of endothelial protection.
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Katz J, Kaufman HE, Goldberg EP, Sheets JW : Prevention of endothelial damage from intraocular lens insertion. Trans Am Acad Ophthalmol and Otolaryngol 1977, 83: 204–12.
Balazs EA : Sodium Hyaluronate and Viscosurgery. In, Miller D, & Stegman eds.: Healon—a guide to its use in ophthalmic surgery. John Wiley & Sons. New York. 1983 5–28.
Binkhorst CD : Inflammation and intraocular pressure after the use of Healon in intraocular lens surgery. Am Intraocular Implant Soc J 1980, 6: 340–1.
Pape LG : Intracapsular and extracapsular techniques of lens implantation with Healon. Am Intraocular Implant Soc J 1980, 6: 342–3.
Percival SPB : Complications from use of sodium hyaluronate (Healonid) in anterior segment surgery. Br J Ophthalmol 1982, 66: 714–6.
Cherfan GM, Rich WJ, Wright G : Raised intraocular pressure and other problems with sodium hyaluronate and cataract surgery. Trans Ophthalmol Soc UK 1983, 103: 227–32.
Fechner PU and Fechner MU : Methylcellulose and lens implantation. Br J Ophthalmol 1983, 67: 259–63.
Barron BA, Busin M, Page C, et al.: Comparison of the effects of Viscoat and Healon on postoperative intraocular pressure. Am J Ophthalmol 1985, 100: 377–84.
Hoffer JK : Effects of extracapsular implant techniques on endothelial cell density. Arch Ophthalmol 1982, 100: 791–2.
Aron-Rosa D, Cohn HC, Aron J-J, Bouquety C : Methylcellulose instead of Healon in extracapsular surgery with intraocular lens implantation. Am Acad Ophthalmol 1983, 90: 1235–8.
Rosen ES, Gregory PF, Barnett F : Is 2 per cent hydroxypropylmethylcellulose a safe solution for intraoperative clinical application? J Cataract Refract Surg 1986, 12: 679–84.
MacRae SM, Edelhauser HF, Hyndiuk RA, et al.: The effects of sodium hyaluronate, chondroitin sulphate and methylcellulose on the corneal endothelium and intraocular pressure. Am J Ophthalmol 1983, 95: 332–41.
Glasser BD, Matsuda M, Edelhauser HF : A comparison of the efficacy and toxicity of and intraocular pressure response to viscous solutions in the anterior chamber. Arch Ophthalmol 1986, 104: 1819–24.
Matsuda M, Sawa M, Edelhauser HF, et al.: Cellular migration and morphology in corneal endothelial wound repair. Invest Ophthalmol Vis Sci 1985, 26: 443–9.
Yee R, Geroski D, Matsuda M, et al.: Correlation of corneal endothelial pump site density, barrier function and morphology in wound repair. Invest Ophthalmol Vis Sci 1985, 26: 1191–201.
Schultz RO, Glasser DB, Matsuda M. et al.: Response of the corneal endothelium to cataract surgery. Arch Ophthalmol 1986, 104: 1164–9.
Sherrard ES and Buckley RJ : Endothelial wrinkling—a complication of clinical specular microscopy. In Trevor-Roper P. ed. The cornea in health and disease VI Cong Euro Soc Ophthalmol Academic Press Inc London. 1980 69–74.
Bourne WM, Brubaker RF, O'Fallo WM : Use of air to decrease endothelial cell loss during intraocular lens implantation. Arch Ophthalmol 1979, 97: 1473–5.
Eiferman RA and Wilkins EL : The effect of air on human corneal endothelium. Am J Ophthalmol 1981, 92: 328–31.
Alpar JJ : The use of Healon in corneal transplant surgery with and without intraocular lenses. Ophthalmic Surg 1984, 15: 757–60.
Leibowitz HM and Laing RA : Corneal endothelium: The effect of air in the anterior chamber. Arch Ophthalmol 1974, 92: 227–30.
Sherrard ES : The corneal endothelium in vivo: its response to mild trauma. Exp Eye Res 1976, 3: 47–57.
Graue EL, Polack FM, Balasz EA : The protective effect of Na-hyaluronate to corneal endothelium. Exp Eye Res 1980, 31: 119–27.
Bahn CF, Grosserode R, MacCallum DK, et al.: Effect of Healon on feline corneal endothelium. Invest Ophthalmol Vis Sci 1983 Suppl 24 175.
Miyauchi S and Iwata S : Biochemical studies on the use of sodium hyaluronate in the anterior eye segment: IV the protective efficacy of the corneal endothelium. Curr Eye Res 1984, 3: 1063–7.
Hammer ME and Burch TG : Viscous corneal protection by sodium hyaluronate, chondroitin sulphate, and methylcellulose. Invest Ophthalmol Vis Sci 1984, 25: 1329–32.
Miller D and Stegman R : Use of sodium hyaluronate in human IOL implantation. Ann Ophthalmol 1981, 13: 811–5.
Stegmann R and Miller D . Extracapsular cataract extraction with Healon using a corneal incision. In Miller D and Stegman R eds.: Healon—a guide to its use in ophthalmic surgery. John Wiley & Sons New York 1983 45–47.
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Presented at the Annual Meeting of the Ophthalmological Society of the United Kingdom, April 1987.
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Muir, M., Sherrard, E., Andrews, V. et al. Air, methylcellulose, sodium hyaluronate and the corneal endothelium. Endothelial protective agents. Eye 1, 480–486 (1987). https://doi.org/10.1038/eye.1987.72
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DOI: https://doi.org/10.1038/eye.1987.72
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