Hydroimplantation versus viscoimplantation: comparison of intraocular lens implantation with and without ophthalmic viscoelastic device in phacoemulsification

Purpose: To compare the efficacy and safety of intraocular lens implantation with and without ophthalmic viscoelastic device in phacoemulsification. Methods: A randomized prospective study was conducted on 84 eyes of 84 patients who underwent uneventful phacoemulsification by the same surgeon. Patients were divided into two groups after the completion of lens cortex removal. Intraocular lens implantation was performed with balanced salt solution irrigation in group H (n=42, hydroimplantation) and with ophthalmic viscoelastic device in group V (n=42, viscoimplantation). The main outcomes measured were postoperative changes of intraocular pressure (IOP), central corneal thickness (CCT), mean absolute refractive error, time of surgery, and the frequency of complications. Patients were evaluated 1 day, 1 week, and 1 month postoperatively. Results: There was no significant difference in mean age, gender, preoperative IOP and preoperative CCT between the two groups. IOP and CCT were not significantly different 1 day, 1 week, and 1 month postoperatively between the two groups. Mean absolute refractive error was also not significantly different between the two groups. Time of surgery was significantly lower in group H than in group V (953.81 ± 88.33 seconds, 1072.33 ± 172.16 seconds, respectively, p<0.001). No other complications were observed during the intraocular lens implantation in the two groups. Conclusions: Hydroimplantation technique is safe and effective in phacoemulsification. Furthermore, reduced time of surgery and reduced cost of ophthalmic viscoelastic devices are the advantages of this technique. Abbreviations: OVDs = ophthalmic viscosurgical devices; IOP = intraocular pressure; MARE = mean absolute refractive error; CCT = central corneal thickness; CDE = cumulative dissipated energy; AL = axial length; ACD = anterior chamber depth; ACM = anterior chamber maintainer; ECCE = extracapsular cataract extraction