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.
What kind of evidence is this?
Human
Prospective randomized double-masked paired-eye clinical trial
Eye health
Other forms
Not reported in this record.
Not reported in this record.
Methods at a glance
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.
Not applicable — the reported 10 mL/min is liquid irrigation flow, not H₂ gas flow.
No O₂ was co-delivered as part of the H₂ intervention.
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. Null findings, outcome type, study design and precision all matter.
Cautions 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.
Not reported in this record.
Not reported in this record.
Not reported in this record.
No single-study GRADE certainty rating is assigned. Certainty is assessed by important outcome across a complete eligible evidence set, not by attaching a final grade to one source.
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.
2026-08-10