Postoperative intraocular pressure changes with use of different viscoelastics

Ophthalmic Surg. 1994 Aug;25(8):540-4.


Sixty eyes with age-related cataract underwent extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC-IOL) implantation under similar conditions using hydroxypropyl methylcellulose (HPMC) (Oculose) (n = 20), sodium hyaluronate (Healon) (n = 20), or hyaluronic acid (IAL) (n = 20) as the viscoelastic (VE). Postoperative evaluation was performed for intraocular pressure (IOP), corneal thickness, and anterior chamber reaction at 6, 24, 48, 72 hours, and 10 days. Statistically-significant rises in IOP with IAL and Healon were observed at 6 and 24 hours; no such rises were observed with Oculose (P < .05). Seven eyes in the IAL group and six in the Healon group had IOPs greater than 22 mm Hg at 6 hours (range: 22 to 38 mm Hg and 22 to 28 mm Hg, respectively). A significant increase in average corneal thickness was observed in all of the 60 patients at 6 hours (18.5%). The average thickness decreased to 6.8% by day 10, with no intergroup variations. There were significantly fewer anterior chamber cells at 6 hours in the Healon group. We conclude that all three viscoelastics are equally useful for routine ECCE with PC-IOL implantation. However, IAL and Healon do cause an early postoperative IOP increase, which, though transient, should be treated.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Anterior Chamber / pathology
  • Cataract Extraction* / adverse effects
  • Humans
  • Hyaluronic Acid*
  • Hypromellose Derivatives
  • Intraocular Pressure*
  • Lenses, Intraocular
  • Methylcellulose / analogs & derivatives*
  • Ocular Hypertension / etiology
  • Postoperative Complications
  • Single-Blind Method


  • Hypromellose Derivatives
  • Hyaluronic Acid
  • Methylcellulose