Prospective randomized comparison of DisCoVisc and Healon5 in phacoemulsification and intraocular lens implantation

Abstract

To compare two ophthalmic viscosurgical devices (OVDs), DisCoVisc (viscous dispersive) and Healon5 (viscoadaptive), in terms of their overall clinical performance during phacoemulsification and intraocular lens (IOL) implantation. In 323 patients (DisCoVisc; 157, Healon5; 166), the surgeons evaluated on a three-point scale, the maintenance of anterior chamber (AC) during continuous curvilinear capsulorhexis (CCC), maintenance of AC during IOL implantation, retention during phacoemulsification, ease of injection, facilitation of CCC, transparency during surgery, and ease of removal from the eye. The time needed to completely remove OVDs after IOL implantation was measured. Masked examiners measured intraocular pressure (IOP), corneal thickness, and corneal endothelial cell count up to 90 days postoperatively. DisCoVisc was assessed to be significantly better than Healon5 in maintenance of AC during CCC (P=0.0008, Cochran-Mantel-Haenszel test) and IOL implantation (P=0.0055), retention during phacoemulsification (P=0.0009), ease of injection (P<0.0001), facilitation of CCC (P<0.0001), transparency (P<0.0001), and ease of removal (P<0.0001). The washout time was 29.6+/-13.4 and 36.2+/-17.5 s in the DisCoVisc and Healon5 groups, respectively (P=0.0002, unpaired t-test). The mean endothelial cell loss was 1.8+/-8.7% in the DisCoVisc group and 3.8+/-8.3% in the Healon5 group (P=0.0358). There were no statistically significant between-group differences in IOP and corneal thickness. DisCoVisc was better retained in the eye during phacoemulsification and was easier to remove after IOL implantation. The corneal endothelial cell loss was significantly less with DisCoVisc than with Healon5. It was indicated that the whole surgical process can be efficiently covered by DisCoVisc alone.