Rev Bras Oftalmol.2025;84:e0088
Comparison between dispersive hidroxypropylmethylcellulose and sodium hyaluronate in phacoemulsification: a systematic review and meta-analysis
DOI: 10.37039/1982.8551.20250088
ABSTRACT
Background:
There is a debate regarding the differences in intraocular pressure values between different types of dispersive ophthalmic viscosurgical devices in patients after phacoemulsification for cataracts.
Objectives:
We aim to evaluate the differences between hydroxypropyl methylcellulose and sodium hyaluronate alone or combined with chondroitin sulfate as ophthalmic viscosurgical devices after phacoemulsification in selected patients related to intraocular pressure.
Methods:
We conducted a systematic review and meta-analysis of randomized clinical trial data comparing only dispersive hydroxypropyl methylcellulose with sodium hyaluronate and hydroxypropyl methylcellulose with sodium hyaluronate combined with chondroitin sulfate in intraocular pressure operative day outcomes. Mean differences were calculated for continuous outcomes. We used Review Manager 5.3 (Cochrane Centre, The Cochrane Collaboration, Denmark) for statistical analysis.
Results:
Six studies, including 489 eyes undergoing senile phacoemulsification, were analyzed; 246 eyes (50.3%) received hydroxypropyl methylcellulose 2% and 3%; 149 eyes (29.44%) received sodium hyaluronate 1%, and 99 eyes (20.24%) received sodium hyaluronate 1.6% and/or 3% sodium hyaluronate combined with chondroitin sulfate 4%. Overall, there were no significant differences between groups on the seventh post-operative day in hydroxypropyl methylcellulose versus sodium hyaluronate (MD 0.00 mmHg; 95%CI −0.50-0.49; I2 =0%) and hydroxypropyl methylcellulose versus sodium hyaluronate combined with chondroitin sulfate (MD −0.25 mmHg; 95%CI −1.05-0.54; I2 = 0%). But a significant statistically difference was found on the first post-operative day in hydroxypropyl methylcellulose versus sodium hyaluronate (MD-0.93 mmHg; 95%CI −1.66-0.19; I2 = 87%).
Conclusion:
This meta-analysis compared only the following dispersive hydroxypropyl methylcellulose to sodium hyaluronate and sodium hyaluronate combined with chondroitin sulfate in over 400 eyes that underwent phacoemulsification. The findings suggest that in the context of phacoemulsification in cataracts, hydroxypropyl methylcellulose showed similar changes in intraocular pressure from baseline compared to sodium hyaluronate and sodium hyaluronate combined with chondroitin sulfate.
