Comparison of Corneal Wetting Properties of Viscous Eye Lubricant and Balanced Salt Solution to Maintain Optical Clarity During Cataract Surgery

Purpose: To compare the corneal wetting properties of balanced salt solution (BSS) and a viscous eye lubricant during cataract surgery.

Setting: Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.

Design: Prospective randomized controlled study.

Methods: 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.

Results: 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).

Conclusions: 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.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.