Comparison of the clinical performance of Healon 5 and Healon in phacoemulsification

PURPOSE, Healon 5 is a high-molecular-mass fraction of sodium hyaluronate. Its density endows it with a number of viscoelastic characteristics. In this prospective, randomised clinical study we compared the performance of Healon 5 and Healon in phacoemulsification. SETTING. Institute of Ophthalmology, University of Modena and Reggio Emilia, Italy. METHODS. Two groups of patients underwent phacoemulsification and intraocular tens (IOL) implantation. In the first 27 patients Heaton 5 was used as viscoelastic substance during surgery, and in the second 27 Heaton was used. The surgeons subjective comments on the performance of these viscoelastic agents were recorded at the different steps of surgery: injection, capsulorhexis, phacoemulsification, IOL implantation, removal of viscoelastic agent and trasparency throughout the operation. The surgeon's overall impression of the viscoelastics during the whole operation was noted. Tonometry and endothelial cell count were performed in all patients before and after operation. RESULTS. There was no statistical difference between the two groups as regards visual acuity, ocular pressure and endothelial damage. Heaton 5 showed excellent ability to maintain the anterior chamber during capsulorhexis, phacoemulsification and IOL implantation. Removal time with Healon 5 was not appreciably longer than Heaton. CONCLUSIONS. Healon 5 emerges as a very interesting viscoelastic substance. Visibility is better if the anterior chamber is filled completely, Removal is easier if it is aspirated while moving the irrigation aspiration tip with circular movements over the top and around the border of the IOL.