We found that both OVDs had similar performance and safety profiles.
All surgeons know that up to 7 hours after surgery, IOP can rise due the surgical trauma of the procedure. However, pressure can also rise due to remnants of viscoelastic remaining after the procedure is complete.
We found that incidences of IOP peaks and mean IOP were not statistically significantly different between the groups. At 6 hours, the incidence of IOP spikes of 30 mm Hg or higher was 6.5% and 7.2% in Twinvisc and Duovisc groups, respectively (P = 0.846). The incidence of IOP spikes of 24 mm Hg or higher was 16.8% and 25.2%, respectively (P = 0.128).
In the Twinvisc group, the mean postoperative ECC showed a mean cell density loss of 11.7% when compared with baseline measurements. In the Duovisc group, the mean postoperative ECC at 3 months revealed a 9.6% reduction from baseline measurements.
In both groups, endothelial cell loss was statistically significant when compared with baseline value, which is normal. However, there was no statistically significant difference in the mean endothelial cell reduction between the two groups.
Corneal endothelium protection
There was a good protection of the corneal endothelium. On the first postoperative day, there was a slight increase in pachymetry by 9.8%, which went away after a couple of days, which is insignificant. After 90 days, the increase of pachymetry was below 1%.
Inflammatory reactions were mild and reported in both groups at 6 hours, 24 hours and 7 days postoperatively. However, at 30 and 90 days postoperatively, inflammation reduced to baseline levels.
Although no serious adverse events related to the OVDs were reported, the Duovisc group had 20 (17.6%) cases of ocular hypertension, one case of corneal oedema (0.9%), one case (0.9%) of capsule break, and one of bubbles from the cohesive solution. The Twinvisc group had 14 (12.6%) cases of ocular hypertension, one case (0.9%) of corneal oedema, and one patient had (0.9%) cystoid macular oedema.