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Effect of multiple usage of viscoelastics during phacoemulsification on high risk group of corneal endothelial cell loss

Poster Details

First Author: J.Oh KOREA

Co Author(s):    R. Yi   H. Hwang   E. Kim   M. Kim           

Abstract Details


We want to know corneal endothelial cell (CEC) loss in the severe dense cataract and evaluate the protective effect on CEC after phacoemulfication patients with hard nucleus with age of over 80 after multiple usage of viscoelastic substance during phacoemulsification.


Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.


We selected the 72patients 10cataract eyes with hard nucleus and age over 80, who was taken the patient phacoemulsification(Centrium, Alcon, USA) time more than 60seconds without any complication. Cataract surgery was done with routine procedure except additional multiple usage of viscoelastics(Hyaluronic acid 1%). The additional viscoelastics was injection(0.1cc) before chopping and after half of nucleus removed(group I). Group II is patient who underwent phacoemulsification without additional use of viscoelatics in the same age and the same nulceus density, same phacoemulification time as control. We recorded the phacoemulfication time, checked corneal thickness, CEC count at preoperative and postoperative 1day, 1month, 2months.


Increase in corneal thickness on postoperative day 1 in group I was 27%, group II was 42% comparing with preoperative value. On one week after surgery, ratio of clear specular microscopic image of CEC was 70% and 35% in group I and II respectively. On 2 months after surgery, corneal thickness was normalized and loss or corneal endothelial cell was 22% and 31% in each group.


The multiple usage of viscoelastics during the phacoemulsification may protect the damage of the corneal endothelial cells in elder or mature cataract without any special technique devices. And we may expect this procedure can be prevented from bullous keratopathy in hard nucleus cataract

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