COMPARISON OF EFFECT OF SODIUM HYALURONATE AND HYDROXY PROPYL METHYLCELLULOSE ON INTRAOCULAR PRESSURE AFTER CATARACT SURGERY

Hidayatullah Mahsud, Sofia Iqbal, Kamran Khalid, Muhammad Daud Khan, Hashmat Ullah

Abstract


Background: Viscoelastic substances protect the intraocular structures against vibration and mechanical damage. However, these may cause increase in intraocular pressure. The aim of this study was to compare the effect of sodium hyaluronate and hydroxypropyl methylcellulose on intraocular pressure after cataract surgery in the early post-operative period.
Material & Methods: This cross-sectional comparative study included one hundred patients with age related cataract, admitted at KIOMS, Hayatabad Medical Complex, Peshawar, from December 2004 to June 2005. In 50 patients sodium hyaluronate was used and in 50 hydroxyl-propyl-methylcellulose as viscoelastic substance. The surgical procedure in all cases was manual suture-less small incision cataract surgery through scleral tunnel. IOP was measured with Goldmann applanation tonometer pre and post-operatively in the evening on the day of surgery and next morning. Means, standard deviations, percentages, and p-values were measured.
Results: Among 100 patients, 51(51%) were males and 49(49%) females. Age range was 50 to 100 years with a mean of 61.4. Pre-operative IOP in both groups differed slightly (p=0.72). IOP recording in the evening on day following surgery showed a significant rise in both groups. This elevation in IOP was more in the Na-HA group than HPMC group (p=0.003). The IOP returned to almost normal in both groups the next morning following surgery. In the evening on the day of surgery, the IOP rise above 21 mmHg was found in 16(32%) cases in Na- HA and 8(16%) cases in HPMC group. The maximum IOP rise in Na-HA group recorded was 44 mmHg while 33 mmHg in HPMC group. In the next morning, IOP rise above 21 mmHg was recorded in 5(10%) cases in Na-HA and 2(4%) in HPMC group (p>0.05).
Conclusion: Both sodium hyaluronate and hydroxylpropyl methylcellulose significantly increase intraocular pressure in the early postoperative period following cataract surgery. We recommend careful monitoring of IOP following cataract surgery.

Keywords


Glaucoma; Hyaluronic acid; Methylcellulose; Intraocular pressure.

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