Completion rate of continuous curvilinear capsulorhexis in pediatric cataract surgery using different viscoelastic materials

J Cataract Refract Surg. 2004 Jan;30(1):85-8. doi: 10.1016/S0886-3350(03)00669-2.


Purpose: To determine whether viscoelastic materials with a higher viscosity allow better control of the lens capsule, reducing the rate of incomplete continuous curvilinear capsulorhexis (CCC) during pediatric cataract surgery.

Setting: Department of Ophthalmology, University of California, San Francisco Medical Center, San Francisco, California, USA.

Methods: This retrospective study comprised 25 eyes of 18 children who had cataract surgery by 1 surgeon. The type of viscoelastic agent used for the CCC portion of the surgery was obtained from surgical dictations and nursing charts and information on complications during the CCC, from surgical dictations. The patient's age, type of cataract, and intraocular lens placement were also obtained.

Results: A CCC was successfully performed in 7 of 15 eyes (46.7%, mean age 7.6 years) using cohesive Healon (sodium hyaluronate 1%) or dispersive Viscoat (sodium hyaluronate 3%-chondroitin sulfate 4%) viscoelastic material and in 9 of 10 eyes (90%, mean age 6.4 years) using the high-viscosity viscoadaptive agent Healon 5 (sodium hyaluronate 2.3%) (chi square = 4.8900; P<.05). The unsuccessful CCCs in the Healon/Viscoat group were in 2 eyes with mature cataract, 1 eye with posterior polar cataract, 1 eye with posterior subcapsular cataract, and 4 eyes with lamellar cataract. The unsuccessful CCC in the Healon5 group was in 1 eye with mature cataract.

Conclusion: The superviscous properties of Healon5 under low turbulence conditions appear to lead to a higher CCC completion rate in children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Capsulorhexis / methods
  • Capsulorhexis / statistics & numerical data*
  • Cataract Extraction*
  • Child
  • Child, Preschool
  • Chondroitin / administration & dosage*
  • Chondroitin Sulfates
  • Drug Combinations
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Lens Implantation, Intraocular*
  • Retrospective Studies
  • Viscosity


  • Drug Combinations
  • chondroitin sulfate, sodium hyaluronate drug combination
  • Hyaluronic Acid
  • Chondroitin
  • Chondroitin Sulfates