The use of a new viscoelastic substance combined with anaesthetic in cataract surgery by phacoemulsification


COD: 383-390 Categorie: ,

Panagiotis Bournas, Nicolas Condilis, Dimitra Lioumi, Dimitrios Kanellas, Konstantinos Syndikakis, Emmanuel Vaikoussis

Ann. Ital. Chir., 2005; 76: 383-389

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AIM OF THE STUDY: To compare and estimate the safety and efficacy of a new viscoelastic substance combined with anaesthetic
used in phacoemulsification surgery.
METHOD: Eight hundred seventyfour patients observed at the Department of Optlamology and the Department of Family
Medicine of the General State Hospital of Nikea-Piraeus (Greece) submitted to a phacoemulsification surgery for cataract
during a six-month period were randomly divided into two groups of 437 patients each. All patients were operated
using the same scheme of anesthesia, consisting of ropivacaine drops 0.75% and lidocaine gel 2% immediately before
surgery. Viscoelastic without anesthetic was used during the operation of the patients of group 1, while the new viscoelastic
with anesthetic (sodium hyaluronate 1.5% and lidocaine 1%) (viscoanesthetic) was used in group 2. No intravenous
sedation was given to either group. Patients were asked to complete a questionnaire including irritation or pain
sensation during various phases of the operation, after the operation, as well as the degree of satisfaction from the anesthesia
scheme. The participating surgeons were called to estimate post-operative corneal edema.
RESULTS: In the first group of patients (viscoelastic without anesthetic) 15.6% of them reported pain during intraocular
lens insertion, 24.6% reported burning sensation during acetylcholine injection, 17.4% reported pain during placement
of the corneal suture, 4.1% immediate postoperative pain and 1.8% night pain. In the second group of patients (viscoelastic
with anesthetic) the percentages were 1.8%, 3.2%, 4.3%, 3.6% and 1.4% respectively. 78.9% of the first group
and 82.1% of the second group had no corneal edema on the first postoperative day. 91.1% of the patients of the first
group and 97.3% of the second group were satisfied.
CONCLUSION: The new combination of viscoelastic and anesthetic is a safe and efficient choice for the cataract surgeon
who uses only anesthetic drops for cataract operations. It minimizes patients’ complaints and helps in achieving better
cooperation during cataract surgery.