Intraocular pressure and endothelium cell counts after cataract surgery with chitosan and sodium hyaluronate (Healon GV): 3-year follow-up results of a randomised clinical trial.

Introduction: The purpose of this study was to evaluate the long-term effects of chitosan 0.1% and sodium hyaluronate 1.4% (Healon GV(R); Advanced Medical Optics, Santa Ana, CA, USA) on intraocular pressure (IOP) and endothelial cell loss.

Methods: This randomised study comprised 140 eyes of 140 patients with age-related cataracts undergoing phacoemulsification followed by posterior chamber intraocular lens (IOL) implantation; 70 received chitosan 0.1%, and 70 received sodium hyaluronate 1.4%. The IOP was measured with standard Goldman applanation tonometry pre-operatively and 1 day, 1 week, 1 month, 3 months, 1 year and 3 years postoperatively. Endothelial cell counts were performed pre-operatively and 1 week, 1 month, 3 months, 1 year and 3 years postoperatively using a Pro/Koester WFSCM contact endothelial microscope.

Results: There were no significant differences found in postoperative IOP levels among the chitosan and sodium hyaluronate groups (P>0.05). No significant differences were found in postoperative mean endothelial cell counts at all time points between the chitosan and sodium hyaluronate groups (P>0.05).

Conclusion: Chitosan has the same effects as sodium hyaluronate on IOP and endothelium cells counts after cataract surgery and IOL implantation, and therefore may be an alternative ophthalmic viscoelastic device.