Holzer M P, Tetz M R, Auffarth G U, Welt R, Völcker H E
Department of Ophthalmology, Humboldt University Berlin, Campus Virchow Klinikum, Germany.
J Cataract Refract Surg. 2001 Feb;27(2):213-8. doi: 10.1016/s0886-3350(00)00568-x.
To compare the ophthalmic viscoelastic device (OVD) Healon5 (sodium hyaluronate 2.3%) with 4 other commonly used OVDs during phacoemulsification and intraocular lens implantation in terms of influence on intraocular pressure (IOP) postoperatively and endothelial cells preoperatively and postoperatively.
Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Germany.
This clinical randomized prospective study, in which patients and observer were masked, comprised 81 eyes. Seventy-four eyes (mean patient age 71.2 years +/- 7.8 [SD]) completed all preoperative and 5 postoperative examinations. The OVDs used were OcuCoat and Celoftal (hydroxypropyl methylcellulose 2.0%), Viscoat (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%), Healon GV (sodium hyaluronate 1.4%), and Healon5 (sodium hyaluronate 2.3%). Intraocular pressure was measured by standard Goldmann applanation tonometry preoperatively and 4 to 6 and 24 hours and 7, 30, and 90 days postoperatively. Endothelial cell counts were done preoperatively and 90 days postoperatively using a Pro/Koester WFSCM contact endothelial microscope. Exclusion criteria were IOP greater than 21 mm Hg at the preoperative examination, age younger than 40 years, significant corneal pathology, and a history or presence of uveitis or pseudoexfoliation syndrome.
All groups had increased IOP 4 hours postoperatively. The Healon5 group had the highest mean pressure (24.9 mm Hg) followed by the Viscoat group (23.6 mm Hg). The mean IOP in the other OVD groups was less than 22.1 mm Hg. These differences were not significant. Twenty-four hours postoperatively and at all subsequent examinations, mean IOP was below 20 mm Hg. The Healon5 group had the lowest mean endothelial cell loss (6.2%), significantly lower than in the other groups (P < .02).
With all 5 OVDs, endothelial cell loss was found, with the lowest in the Healon5 group, and IOP was increased 4 to 6 hours postoperatively. After 24 hours, no significant increases in IOP were noted.
在白内障超声乳化吸除及人工晶状体植入术中，比较眼科粘弹剂Healon5（透明质酸钠2.3%）与其他4种常用眼科粘弹剂对术后眼压及术前、术后内皮细胞的影响。
德国海德堡鲁普雷希特-卡尔斯大学眼科。
本临床随机前瞻性研究对患者和观察者设盲，纳入81只眼。74只眼（患者平均年龄71.2岁±7.8[标准差]）完成了所有术前及5次术后检查。所用的眼科粘弹剂有OcuCoat和Celoftal（羟丙基甲基纤维素2.0%）、Viscoat（透明质酸钠3.0%-硫酸软骨素4.0%）、Healon GV（透明质酸钠1.4%）和Healon5（透明质酸钠2.3%）。术前及术后4至6小时、24小时、7天、30天和90天用标准Goldmann压平眼压计测量眼压。术前及术后90天使用Pro/Koester WFSCM接触式内皮显微镜进行内皮细胞计数。排除标准为术前眼压高于21mmHg、年龄小于40岁、明显的角膜病变以及有葡萄膜炎或假性剥脱综合征病史或存在该病症。
所有组术后4小时眼压均升高。Healon5组平均眼压最高（24.9mmHg），其次是Viscoat组（23.6mmHg）。其他眼科粘弹剂组的平均眼压低于22.1mmHg。这些差异无统计学意义。术后24小时及所有后续检查中，平均眼压低于20mmHg。Healon5组内皮细胞平均损失最低（6.2%），显著低于其他组（P<.02）。
使用所有5种眼科粘弹剂均发现有内皮细胞损失，Healon5组损失最低，且术后4至6小时眼压升高。24小时后，未观察到眼压有显著升高。
