Phacoemulsification Cataract Surgery without Ophthalmic Viscoelastic Devices: A Randomized Controlled Trial

Ammar Adil Fahad ^1*

This study showed phacoemulsification outcomes with/without OVDs, demonstrating cost-effectiveness and safety without increased intraocular pressure.

Abstract

Background: Phacoemulsification is a widely used method for cataract removal. The use of ophthalmic viscosurgical devices (OVDs) in this procedure is common, but their necessity and cost-effectiveness are questioned. This study aimed to determine the outcomes of phacoemulsification cataract surgery with and without OVDs. Methods: This prospective, randomized trial included 90 eyes, divided into two equal groups (n = 45 each). Group A underwent cataract surgery with OVDs, while Group B underwent surgery without OVDs. The study was conducted between December 2022 and December 2023 in Iraq. Intraoperative adverse effects, surgical duration, and surgical difficulty were recorded. Results: No significant differences were found between the groups in terms of age, axial length, IOL power, pre-operative and postoperative intraocular pressure (IOP), and central corneal thickness (CCT). The mean surgery time was 9.12±8.85 minutes for Group A and 10.80±1.35 minutes for Group B (p=0.791). Surgical difficulty was reported in 17.8% of Group A and 8.89% of Group B. Implantation problems were similar between groups, including wound leaks, flipped IOLs, haptic breakages, and sulcus implantations. Conclusions: Phacoemulsification cataract surgery without OVDs yielded comparable outcomes to surgery with OVDs. This approach may reduce costs and eliminate the risk of increased IOP associated with OVD use.

Keywords: Phacoemulsification, Ophthalmic Viscoelastic Device (OVD), Cataract Surgery, Intraocular Pressure, Surgical Outcomes

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