No more irrigation during surgery: a new protective solution

Purpose: eyeDRO is a novel corneal gel intended to maintain corneal hydration and clarity during eye surgery. The aim of the present study was to evaluate the effect of the gel on intraoperative and postoperative corneal transparency, epithelial damage and patient discomfort in phacoemulsification cataract surgery as compared to balanced salt solution (BSS) irrigation.

Methods: Fifty uncomplicated cataract patients, aged from 50 to 83 years, were enrolled in a prospective  study. Thirty patients underwent phacoemulsification cataract surgery using Infinity equipment (Alcon, USA) and a single application of eyeDRO (Alchimia, Italy) as corneal surface coating. Twenty control eyes were irrigated with BSS solution (Alcon, USA). Surgeon scored intraoperative clarity of operative field and ease of manipulation. Two and 24 hours postoperatively, eye was examined by slit lamp (Nikon, Japan) for transparency. Extent of epithelial damage was determined by fluorescein staining and all patients filled a questionnaire on eye discomfort.

Results: Surgeon reported excellent clarity of operative field and ease of manipulation in 98% and 78% of eyeDRO-treated and control eyes, respectively. Postoperative slit lamp evaluation showed similar corneal transparency for both groups. Incidence of superficial punctiform keratitis was lower in eyeDRO group than in control group. Fluorescein staining showed a significant reduction of epithelial damage in eyeDRO group. Postoperative eye irritation and foreign object sensation was reported by 9% and 28% patients treated with eyeDRO and BSS, respectively.

Conclusions: The new eyeDRO gel exhibited an excellent clarity and stability of operative field, along with protective effects on corneal epithelium and significant reduction of patients discomfort as compared to BSS corneal irrigation during phacoemulsification cataract surgery.