Assuntos
Condroitina/uso terapêutico , Suplementos Nutricionais , Glucosamina/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico , Apoio à Pesquisa como Assunto , Condroitina/economia , Suplementos Nutricionais/economia , Revelação , Glucosamina/economia , Humanos , Osteoartrite do Joelho/economia , Medição da Dor/economiaRESUMO
PURPOSE: To evaluate the protective effect on corneal endothelial cells of a low-cost and an expensive combination of a dispersive viscoelastic material and an irrigating solution during phacoemulsification. SETTING: Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS: This prospective randomized examiner- and patient-masked study comprised 90 eyes of 45 consecutive patients with age-related cataract in both eyes. For each patient, the first eye was randomly assigned to receive hydroxypropyl methylcellulose 2% (Ocucoat) and Ringer's solution (low-cost combination) or sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) and an enriched balanced salt solution (BSS Plus) (expensive combination) during phacoemulsification. The contralateral eye received the other treatment. Endothelial cell function was evaluated by measuring corneal thickness (CT) using partial coherence interferometry, morphology assessment, and endothelial cell counts. RESULTS: The acute postoperative increase in CT was +9.8 microm in the low-cost group and +10.9 microm in the expensive group; the difference between groups was not significant. After 1 month, the CT still differed significantly from baseline in the low-cost group. Three months after surgery, the CT had returned to baseline values in both groups. There was no significant between-group difference in endothelial cell counts or morphology. CONCLUSIONS: During phacoemulsification in a nonselected patient population, there was no difference in acute postoperative corneal edema and endothelial cell morphology after 3 months between a Viscoat and BSS Plus combination and an Ocucoat and Ringer's solution combination. Eyes receiving the expensive combination had marginally faster recovery of corneal swelling by 3 months. However, the cost of Viscoat and 500 mL BSS Plus is 5 times that of Ocucoat and Ringer's solution.
Assuntos
Bicarbonatos/uso terapêutico , Condroitina/uso terapêutico , Edema da Córnea/prevenção & controle , Endotélio Corneano/efeitos dos fármacos , Glutationa/uso terapêutico , Ácido Hialurônico/uso terapêutico , Soluções Isotônicas/uso terapêutico , Metilcelulose/análogos & derivados , Metilcelulose/uso terapêutico , Facoemulsificação/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Bicarbonatos/economia , Contagem de Células , Condroitina/economia , Sulfatos de Condroitina , Edema da Córnea/economia , Edema da Córnea/etiologia , Citoproteção/efeitos dos fármacos , Método Duplo-Cego , Combinação de Medicamentos , Custos de Medicamentos , Quimioterapia Combinada , Endotélio Corneano/patologia , Glutationa/economia , Humanos , Ácido Hialurônico/economia , Derivados da Hipromelose , Soluções Isotônicas/economia , Metilcelulose/economia , Pessoa de Meia-Idade , Soluções Oftálmicas/economia , Soluções Oftálmicas/uso terapêutico , Facoemulsificação/economia , Estudos Prospectivos , Solução de RingerRESUMO
Glucosamine and chondroitin supplements appear to ease arthritis symptoms and possibly fight the disease itself. We tested 19 national products.