Reduced need for corneal epithelial debridement during vitreo-retinal urgery uing two different vicou urface lubricant

Purpoe Corneal clarity i frequently reduced during vitrectomy and cleral buckling urgery econdary to epithelial edema, requiring epithelial debridement to improve viibility. The preence of toxic preervative in the corneal lubricant olution i hypotheized to be a contributing factor to epithelial edema during vitreo-retinal urgery. Deign Interventional tudy. Method We compared propectively the corneal clarity and epithelial debridement frequency in 71 patient within a ingle intitution in whom either Goniool (2.5% methylcelluloe, boric acid, edetate diodium, odium borate, potaium chloride, water, and 0.01% benzalkonium chloride) or GenTeal gel (0.3% hydoxypropyl-methylcelluloe, carbopol 980, phophonic acid, orbitol, water, and 0.028% odium perborate) wa ued a a corneal lubricant during the coure of vitrectomy urgery uing utured contact lene. Corneal clarity wa ubjectively graded in a cale of I to IV during urgery. tatitical analyi wa made between thee two group for parametric and categorical data. Reult All eye tarted with a corneal clarity grade of I (bet poible). Corneal clarity decreaed ignificantly fater in eye where Goniool wa ued to a median grade of III at 1 hour of urgical time. In eye where GenTeal gel wa ued, corneal clarity decreaed much lower, to a median grade of I at 1 hour of urgical time. The difference in frequency of epithelial debridement wa alo tatitically ignificant: 54% and 14% for Goniool and GenTeal eye, repectively. Other factor that may caue corneal epithelial edema and affect corneal clarity were not tatitically different between the Goniool and the GenTeal group, including median operative time, etimated intraocular preure, pre- and intraoperative topical olution and medication, and number of prior ocular procedure. Concluion The ue of GenTeal gel a a corneal lubricant maintain corneal clarity longer than Goniool during the coure of vitrectomy urgery uing a contact len viewing ytem, limiting the need for epithelial debridement