Intraocular pressure after small incision cataract surgery with Healon5 and Viscoat

PURPOSE: To evaluate the effect of Healon5 (sodium hyaluronate) and Viscoat (sodium chondroitin sulfate-sodium hyaluronate) on intraocular pressure (IOP) after bilateral small incision cataract surgery. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This prospective randomized study comprised 70 eyes of 35 consecutive patients with age-related cataract in both eyes scheduled for bilateral small incision cataract surgery. The patients were randomly assigned to receive Healon5 or Viscoat during cataract surgery in the first eye. The second eye received the other viscoelastic substance. Cataract surgery was performed in an identical fashion in both eyes, with a temporal 3.5 mm sutureless posterior limbal incision, phacoemulsification, and implantation of a foldable silicone intraocular lens. The IOP was measured preoperatively and 6 hours, 20 to 24 hours, and 1 week postoperatively. RESULTS: At 6 hours after surgery, the mean IOP increased by 5.2 mm Hg +/- 5.3 (SD) in the Healon5 group (P < .0001) and by 10.1 +/- 8.7 mm Hg in the Viscoat group (P < .0001). The increase was significantly higher in the Viscoat group than in the Healon5 group (P = .0016). Intraocular pressure spikes of 30 mm Hg or more occurred in 2 eyes in the Healon5 group and in 10 eyes in the Viscoat group (P = .0112). Twenty to 24 hours and 1 week postoperatively, the mean IOP in the 2 groups was not statistically different. CONCLUSIONS: Viscoat caused a significantly higher IOP increase and significantly more IOP spikes than Healon5 in the early period after small incision cataract surgery.