Foldable intra ocular lens hydroimplantation Versus viscoimplantation during phacoemulsification: Comparative study

Background: Viscosurgical devices created a revolution in progress of cataract surgery but with great advancement in cataract surgery and their corneal incisions, anterior chamber and bag stability can be achieved with other methods otherwise viscosurgecal devices and the best method is hydroimplantation. Hydroimplantation can achieve the same effect like viscoimplantation with achieving approximate safety on ocular structures especially corneal endothelium and posterior capsule. Purpose: To compare implantation of a singl-piece, foldable intraocular lens (IOL) using hydroimplantation to that of a standard implantation using an ophthalmic viscoelastic device ( OVD) in terms of safety, frequency of complications during implantation, influence of the method on endothelial cell density (ECD), and postoperative changes in IOP. Methods: A prospective comparative clinical study was conducted on 120 eyes of 120 patients who underwent uneventful phacoemulsification by the same surgeon. Patients were divided into two groups after the completion of lens cortex removal. IOL implantation was performed with balanced salt solution irrigation in group H (n=60, hydroimplantation) and with OVD in group V (n=60, viscoimplantation). The main outcomes measured were postoperative changes of intraocular pressure (IOP), Corneal endothelium cell characteristics, time of surgery, and the frequency of complications. Results: Time of surgery was significantly lower in group H than in group V (7.2±1.1 minutes, 8.0±1.3 minutes, respectively, p 0.001). There was statistically significant difference between both groups as regard; post operative IOP after 1 day and 1 week. There was statistically significant difference regarding IOP spikes; BCVA after 1 week. Conclusions: Hydroimplantation technique is safe and effective in phacoemulsification. Furthermore, reduced time of surgery and reduced cost of OVDs are the advantages of this technique.