Methylcellulose instead of Healon in extracapsular surgery with intraocular lens implantation

Methylcellulose 1% was used in the anterior chamber to facilitate posterior chamber lens implantation at the time of extracapsular cataract extraction. In parallel series with similar preoperative endothelial cell counts, 70 eyes implanted under methylcellulose had a mean central endothelial cell loss of 8 +/- 5.3% at 8 to 12 weeks postoperative, whereas 63 eyes implanted under an air bubble lost a mean 25.3 +/- 14.6% (P less than 0.001). No differences in postoperative visual acuity, intraocular pressure, or inflammation were noted. A YAG laser preoperative anterior capsulotomy was used in all cases, and may have contributed to overall preservation of endothelial cells.