Natural course of intraocular pressure after cataract surgery with sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat)

Ophthalmology. 2005 Oct;112(10):1714-8. doi: 10.1016/j.ophtha.2005.05.011.


Purpose: To investigate the natural course of intraocular pressure (IOP) and its peak after small-incision cataract surgery with chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat, Alcon Laboratories, Inc., Fort Worth, TX).

Design: Observational case series.

Participants: This prospective study comprised 40 eyes of 40 consecutive cataract patients scheduled for small-incision cataract surgery.

Methods: Cataract surgery was performed with sodium chondroitin sulfate 4%-sodium hyaluronate 3% as the ophthalmic viscosurgical device, which was removed as completely as possible from the eye at the end of surgery. The IOP was measured preoperatively and 30 minutes; 1, 2, 3, 4, 6, 8, and 20 to 24 hours; and 1 week postoperatively.

Main outcome measures: Postoperative IOP increase.

Results: The mean IOP increased significantly at all observation times during the first 20 to 24 hours, with a peak increase of 13.4+/-9.4 mmHg after 1 hour (P<0.05). In all, 28 eyes (70%) had an IOP spike to 30 mmHg or higher. Sixty-eight percent of these spikes occurred at 30 minutes as well as at 1 hour and 2 hours postoperatively. At 20 to 24 hours, no eye had an IOP spike to 30 mmHg or higher.

Conclusions: Significant IOP increases were found during the first 24 hours, peaking at 1 hour after surgery. With a single postoperative IOP measurement, between 30 minutes and 2 hours after surgery, two thirds of these IOP spikes could be detected. To detect all IOP spikes, a second measurement between 4 and 6 hours after surgery would be necessary.

MeSH terms

  • Aged
  • Chondroitin Sulfates
  • Chondroitin*
  • Drug Combinations
  • Female
  • Humans
  • Hyaluronic Acid*
  • Intraocular Pressure*
  • Lens Implantation, Intraocular
  • Male
  • Ocular Hypertension / etiology*
  • Phacoemulsification / methods*
  • Postoperative Complications*
  • Postoperative Period
  • Prospective Studies
  • Time Factors
  • Tonometry, Ocular


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