The effect of sodium hyaluronate on endothelial cell damage during extracapsular cataract extraction and posterior chamber lens implantation.

We conducted a prospective, randomized clinical trial of the use of 1% sodium hyaluronate (Healon) in the anterior chamber during anterior capsulotomy and nuclear expression in extracapsular cataract extraction with posterior chamber lens implantation. Two months postoperatively, the mean (+/- standard deviation) central endothelial cell loss was 6.1% +/- 11.4% in 92 eyes in which sodium hyaluronate was used for the capsulotomy and nuclear expression and 7.6% +/- 14.7% in 89 eyes in which it was not used (P greater than .6). Sodium hyaluronate was also used later in the procedure in all eyes to expand the capsular bag to facilitate lens implantation. No significant difference was noted between the two groups in the increase in intraocular pressure on the first postoperative day (mean increase, 4 mm Hg in each group) or in the corneal thicknesses preoperatively and two months postoperatively (no significant change in either group). Sodium hyaluronate was useful in maintaining the anterior chamber during difficult surgical cases.