A comparison of Healon and Amvisc on the early postoperative pressure after extracapsular cataract extraction with implantation of posterior chamber lens

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Abstract
Two viscoelastic agents, Healon and Amvisc, both hyaluronic acids, were evaluated in two prospective, randomized and masked studies in order to compare the effects of the viscoelastics and timolol (Blocadren ) on the early postoperative intraocular pressure (IOP) after planned extracapsular cataract extraction with implantation of a posterior chamber lens. The study protocols were similar, especially with regard to the sample size, pre-, per- and postoperative management and sampling. The IOP was measured preoperatively, 3-6 and 24 h postoperatively. The testing of Amvisc revealed that aspiration or non-aspiration of Amvisc at the end of surgery was of little importance for the IOP, and that timolol significantly reduced the IOP 3-6 h postoperatively in the order of about 8 mmHg. The postoperative IOP was lower for Amvisc than for Healon only when the viscoelastic material was aspirated and topical timolol was administered. In all the other groups there were no significant differences between the viscoelastics as far as the postoperative pressure was concerned. Multiple regression revealed a marked pressure reducing effect of timolol 3-6 h postoperatively in both groups, but no effect was observed 24 h postoperatively. The two viscoelastic agents showed minor effect on the IOP both 3-6 and 24 h postoperatively.