Effects of Hydrogen in Prevention of Corneal Endothelial Damage During Phacoemulsification: A Prospective Randomized Clinical Trial
Igarashi T et al. · Am J Ophthalmol. 2019;207:10–17.
Study at a glance
Human
Adults with bilateral cataracts undergoing phacoemulsification
Phacoemulsification using an irrigation solution saturated under a 100% H₂ atmosphere for 24 hours · The article reports 61.9% H₂ saturation before use and 53.7% after 30 minutes of continuous irrigation; these are saturation percentages, not gas-mixture percentages or ppm.
Surgery with follow-up at day 1 and weeks 1 and 3
Endothelial-cell loss was lower with H₂ irrigation at day 1 (6.5% vs 16.0%, p=0.003), week 1 (9.3% vs 15.4%, p=0.039) and week 3 (8.5% vs 18.4%, p=0.004).
Only 32 patients at one center, paired-eye design, three-week follow-up and a surrogate cellular endpoint. The H₂ concentration is reported as percentage saturation rather than ppm.
What kind of evidence is this?
Human
Prospective randomized double-masked paired-eye clinical trial
Eye health
Other forms
Information not yet classified
Some editorial classification fields are still pending. The source-reported outcomes and result are shown below; Hydrogenology does not infer a positive or negative signal from prose automatically.
Methods
Adults with bilateral cataracts undergoing phacoemulsification
32 patients; one eye randomized to H₂-dissolved irrigation and the fellow eye to conventional irrigation
Surgery with follow-up at day 1 and weeks 1 and 3
Phacoemulsification using an irrigation solution saturated under a 100% H₂ atmosphere for 24 hours
H₂ dissolved in ophthalmic irrigation solution — H₂ only, not Brown’s gas and not inhalation.
The article reports 61.9% H₂ saturation before use and 53.7% after 30 minutes of continuous irrigation; these are saturation percentages, not gas-mixture percentages or ppm.
Conventional irrigation solution in the contralateral eye
Outcomes and reported result
Corneal endothelial cell density and percentage endothelial-cell loss
Endothelial-cell loss was lower with H₂ irrigation at day 1 (6.5% vs 16.0%, p=0.003), week 1 (9.3% vs 15.4%, p=0.039) and week 3 (8.5% vs 18.4%, p=0.004).
Intervention preparation, principal outcomes and follow-up checked in the open-access article; independent appraisal remains incomplete.
A reported association, difference or mechanism is not automatically a clinical benefit.
Limitations and applicability
Only 32 patients at one center, paired-eye design, three-week follow-up and a surrogate cellular endpoint. The H₂ concentration is reported as percentage saturation rather than ppm.
Adults with bilateral cataracts undergoing this specific phacoemulsification protocol; not other eye diseases or systemic H₂ therapy.
No single-study GRADE certainty rating is assigned. Read how records and evidence assessments are prepared.
Sources and record status
PMID: 31077667 · DOI: 10.1016/j.ajo.2019.04.014
Open-access publisher article.
Open-access publisher full text and PubMed bibliographic record.
10 August 2026
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