Corneal endothelial cell coating during phacoemulsification using a new dispersive hyaluronic acid ophthalmic viscosurgical device

PURPOSE: To compare the corneal endothelial coating of a new hyaluronic acid ophthalmic viscosurgical device (OVD) with dispersive properties with that of a standard hyaluronic acid OVD with cohesive properties. SETTING: David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany. DESIGN: Experimental study. METHODS: The corneal endothelial cell coating of a new dispersive OVD (sodium hyaluronate 3% [Healon Endocoat]) and a standard cohesive hyaluronic acid OVD (sodium hyaluronate 1.4% [Healon GV]) as well as their combination using the soft-shell technique were evaluated. All OVDs were stained with fluorescein. Each of the 3 test groups comprised 10 porcine eyes. Cataract surgery was performed with identical phacoemulsification settings and time frames. Afterward, the cornea was trephined and a photograph taken of the endothelial side under blue light. The corneal coating with OVD was evaluated using planimetric image-analysis software. RESULTS: The least endothelial coating was in the cohesive group (71%), while the dispersive group had statistically significantly higher adherence to the endothelium (87%) (P=.0009). The greatest endothelial coating was in the soft-shell technique group (93%); however, the difference between that group and the dispersive group was not statistically significant (P=.0962). CONCLUSION: The new dispersive hyaluronic acid OVD with a low molecular weight showed a greater adherence to the endothelial surface than the standard cohesive hyaluronic acid OVD with a higher molecular weight.