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An Optical Coherence Tomography Study

Karaca, Cagatay, MD*; Ozkose, Mustafa, MD; Unlu, Metin, MD*; Sevim, Duygu Gulmez, MD*; Mirza, Ertugrul, MD*

doi: 10.1097/IAE.0000000000001854
Original Study

Purpose: To compare corneal wetting performances of different dispersive ophthalmic viscosurgical devices.

Methods: Three different types of dispersive ophthalmic viscosurgical devices, hydroxypropyl methylcellulose %2 (HPMC), sodium hyaluronate %3–sodium chondroitin sulphate %4 (HACS), and sodium hyaluronate %3 (HA), were applied on corneal surfaces of 10 healthy volunteer subjects repeatedly at 3 different time points. Corneal wetting properties of the ophthalmic viscosurgical devices were compared qualitatively and quantitatively by anterior segment optical coherence tomography for 30 minutes.

Results: Sodium hyaluronate 3% and HACS applications had a higher mean precorneal ophthalmic viscosurgical device thickness than HPMC application at all time points (seventh minute HPMC: 105.2 ± 25.3 μm, HA: 561.4 ± 115.8 μm, HACS: 481.2 ± 55 μm, P < 0.001). All HPMC applications were terminated by the 12th minute because of insufficient corneal wetting. Mean survival estimate time was significantly shortest for HPMC (11.5 ± 0.5 minutes, P < 0.001) and longest for HA (29.7 ± 0.28 minutes). It was slightly shorter for HACS (26.9 ± 0.87 minutes, P = 0.007) than the HA application.

Conclusion: Sodium hyaluronate 3% and HACS provide superior corneal covering compared with HPMC with an effect that can be maintained up to 30 minutes. They may be an effective option for corneal wetting during long vitreoretinal surgeries with longer duration of effect and fever number of applications.

The presented study examines the corneal wetting properties of three different dispersive ophthalmic viscosurgical devices with anterior segment optical coherence tomography. Sodium hyaluronate 3% and sodium hyaluronate–chondroitin sulphate have been found to provide a thicker precorneal ophthalmic viscosurgical device thickness with a longer duration of corneal wetting compared with hydroxypropyl methylcellulose 2%.

*Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey; and

Department of Ophthalmology, Zile State Hospital, Tokat, Turkey.

Reprint requests: Cagatay Karaca, MD, Department of Ophthalmology, Erciyes University School of Medicine, 38039 Kayseri, Turkey; e-mail:

None of the authors has any financial/conflicting interests to disclose.

The study was performed in Erciyes University School of Medicine.

© 2018 by Ophthalmic Communications Society, Inc.