Comparison of topical 5% NaCl versus 10% Mannitol for the treatment of corneal edema after phacoemulsification

Objective This study aimed to compare the efficacy of topical 5% Sodium Chloride (NaCl) and 10% Mannitol agents in managing corneal edema following uncomplicated cataract surgery. Methods Patients with postoperative corneal edema were enrolled, and they were divided into three groups for comparison. Anterior chamber depth (ACD), axial length (AL), intraocular lens (IOL) power, cumulative dissipated energy (CDE), best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC) were assessed among the groups. Results Fifty-eight eyes of 58 patients were included. The study comprised the NaCl group (using topical 5% NaCl, n = 21), Mannitol group (using topical 10% Mannitol, n = 17), and a control group without osmotic agent use (n = 20). Age, gender, ACD, AL, IOL power, and CDE were similar across groups. Postoperative day-1 CCT values showed no significant difference between groups. Additionally, at postoperative 1 week, CCT values were [663.4 ± 100.2] microns in the NaCl group, [640.4 ± 68.9] microns in the Mannitol group, and [760.3 ± 76.7] microns in the Control group. Although CCT and BCVA values were better in the Mannitol group at postoperative 1 week, no statistically significant difference was found between the groups at 1 week and 1 month postoperatively. Furthermore, corneal edema positively correlated with CDE and negatively correlated with AL. Conclusion Topical 5% NaCl and 10% Mannitol agents are effective and reliable agents that showed faster recovery of corneal edema during the early postoperative period after uncomplicated cataract surgery. The choice between these agents may depend on factors such as patient tolerability, cost, and availability.