Efficacy and Safety of the Use of Ophthalmic Viscosurgical Devices (OVD) FIDIAL PLUS vs IAL®-F During Cataract Surgery

This is a Prospective, single-center, randomized, controlled, paired-eye, single-masked clinical investigation to compare the efficacy and safety of FIDIAL PLUS (bacterial derived 1.8% sodium hyaluronate OVD) and IAL®-F (comparable animal derived 1.8% sodium hyaluronate OVD) while used during phacoemulsification cataract surgery.

Viscoelastics, also referred to as OVDs (ophthalmic viscosurgical devices), are viscous substances that are routinely used in cataract surgery. The most basic benefit of OVD use in ophthalmic surgery is maintaining the anterior chamber during surgical maneuvers. One of the main aspects in OVD use remains the protection of intraocular structures and in particular of corneal endothelium cells (CECs) during cataract surgery.

Eligibility Criteria:
Inclusion Criteria:

1. Subject able to comprehend the full nature and the purpose of the study;
2. Subjects able to cooperate with the Investigator and to comply with the requirements of the entire study;
3. Subject provided written informed consent to participate in the study obtained according to Good Clinical Practice (GCP);
4. Females of childbearing potential (i.e., not permanently sterilised - post hysterectomy or tubal ligation status - or not postmenopausal) must have a negative urine pregnancy test result at Screening and surgery days and must use an appropriate method of contraception for at least 30 days before inclusion in the study and during the whole study period, according to the definition in ICH M3 Guideline.

The following criteria apply to both eyes:

1. Nuclear cataract with visual acuity between 20/200 (logmar 1.0) and 20/32 (logmar 0.2);
2. Intraocular pressure (IOP) between 14 and 21 mmHg (Goldmann tonometer);
3. Previous refraction between -5 and +3 diopters in spherical equivalent;
4. Corneas perfectly transparent without leukoma or other corneal pathology.

Exclusion Criteria:

1. Any acute, chronic or uncontrolled disease as severe heart failure, recent cardiovascular event, respiratory failure, severe hepatic or renal disease, poorly controlled diabetes mellitus, active severe autoimmune disease, active malignancy etc. that in the opinion of the Investigator, would increase the risk of operation or affect the outcome of the study;
2. Epilepsy and any other condition that would prevent cooperation during surgery, including head tremor, deafness, neck or back problems, restless legs syndrome, claustrophobia etc.;
3. Have a history of allergic/hypersensitivity reaction to sodium hyaluronate (NaHA);
4. Participation in another clinical trial within the past 30 days;

The following criteria apply both eyes:

1. Corneal endothelium cell density less than 1800 cells/mm square;
2. Pseudoexfoliation syndrome (PEX) or suspected zonular compromise of any origin;
3. Corneal angle narrow or/and glaucoma;
4. Anterior segment pathology likely to increase the risk of an adverse outcome for phacoemulsification cataract surgery (e.g., pseudoexfoliation syndrome, synechiae, iris atrophy, inadequate dilation, shallow anterior chamber, traumatic cataract, lens subluxation etc.);
5. Any corneal irregularity or leukoma (as assessed by slit lamp and specular microscope pachymetry);
6. Complicated cataracts;
7. Subjects requiring implantation of toric lenses;
8. Proliferative retinopathy, macular degeneration or oedema of any origin. Other ocular pathology that may compromise vision despite successful cataract surgery;
9. Signs of ocular or systemic infection and/or inflammation;
10. Previous intraocular surgery, refractive surgery or severe ocular trauma.