Natural Course of Intraocular Pressure after Cataract Surgery with Sodium Hyaluronate 1% versus Hydroxypropylmethylcellulose 2%
Received 4 April 2006; accepted 14 August 2006.
Purpose
To investigate the natural course of intraocular pressure (IOP) after small-incision cataract surgery with sodium hyaluronate 1% versus hydroxypropylmethylcellulose 2%.
Design
Randomized clinical trial.
Participants
Eighty eyes of 40 consecutive patients with bilateral age-related cataract.
Methods
The patients were assigned randomly to receive sodium hyaluronate 1% or hydroxypropylmethylcellulose 2% during cataract surgery in the first eye. The second eye received the other ophthalmic viscosurgical device. The IOP was measured preoperatively and 30 minutes; 1, 2, 3, 4, 6, 8, and 20 to 24 hours; and 1 week postoperatively.
Main Outcome Measure
Postoperative IOP increase.
Results
The highest mean IOP increase occurred at 8 hours postoperatively (5.3±6.4 mmHg) in the sodium hyaluronate 1% group and at 2 hours postoperatively (7.8±6.1 mmHg) in the hydroxypropylmethylcellulose 2% group. Overall, the IOP increase was higher with hydroxypropylmethylcellulose 2% (P = 0.005). Intraocular pressure spikes to ≥30 mmHg occurred in 5 eyes (13%) in the sodium hyaluronate 1% group and 13 eyes (33%) in the hydroxypropylmethylcellulose 2% group.
Conclusions
Sodium hyaluronate 1% and hydroxypropylmethylcellulose 2% caused significant IOP increases during the first 8 hours after cataract surgery. A single measurement at 6 hours postoperatively could detect all IOP spikes in the sodium hyaluronate 1% group. In the hydroxypropylmethylcellulose 2% group, a single measurement at 2 hours postoperatively could detect two thirds of IOP spikes.
1Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
2Section of Clinical Biometrics, Core Unit for Medical Statistics and Informatics, Medical University of Vienna, Vienna, Austria.
Correspondence to Georg Rainer, MD, Associate Professor, Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria.
ABSTRACT