Comparison of corneal wetting properties of viscous eye lubricant and balanced salt solution to maintain optical clarity during cataract surgery

Abstract

To compare the corneal wetting properties of balanced salt solution (BSS) and a viscous eye lubricant during cataract surgery. Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. Prospective randomized controlled study. This randomized controlled subject- and examiner-masked study comprised patients scheduled for cataract surgery. The patients were randomly assigned to receive either BSS or hydroxypropyl methylcellulose (HPMC) 2% gel (Cornea_Protect). Fluorescein staining, optical clarity during surgery, application frequency, subjective grading of discomfort, and subjective dryness of the eye were assessed. One hundred one eyes of 97 patients (mean age 73.6 years; range 53 to 87 years) were included in the study. Mean grade of fluorescein staining was 9.46 ± 3.64 (SD) and 9.76 ± 3.27 (SD) in the BSS group and the HPMC 2% group, respectively (P=.67). Median grade of optical clarity during surgery was 2.0 in the BSS group and 1.0 in the HPMC 2% group, a statistically significant difference (P=.03). Median application frequency of BSS was 10 times higher than median application frequency of 1 time for HPMC 2%, a statistically significant difference (P<.001). Hydroxypropyl methylcellulose 2% provided significantly better optical clarity than BSS during cataract surgery. Because frequent irrigation is not needed and HPMC 2% provides a better view for the surgeon, the use of HPMC 2% results in increased comfort for the patient, especially under topical anaesthesia, and in a simpler and possibly safer surgical procedure. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.