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In phacoemulsification, ultrasound induces hydroxyl radical (·OH) formation, damaging corneal endothelium. Whether H 2  can prevent such oxidative damage in phacoemulsification was examined by  in vitro  and  in vivo  studies. H 2  was dissolved in a commercial irrigating solution. The effects of H 2  against ·OH generation were first confirmed  in vitro  by electron-spin resonance (ESR) and hydroxyphenyl fluorescein (HPF). ESR showed a significantly decreased signal magnitude, and fluorescence intensity by oxidized HPF was significantly less in the H 2 -dissolved solution. The effects of H 2  in phacoemulsification were evaluated in rabbits, comparing H 2 -dissolved and control solutions. Five hours after the procedure, the whole cornea was excised and subjected to image analysis for corneal edema, real-time semiquantitative PCR (qPCR) for heme oxygenase (HO)-1, catalase (CAT), superoxide dismutase 1 (SOD1), and SOD2 mRNA, and immunohistochemistry. Corneal edema was significantly less and the increases in anti-oxidative HO-1, CAT and SOD2 mRNA expressions were significantly suppressed in the H 2  group. In addition, corneal endothelial cell expressions of two oxidative stress markers, 4-HNE and 8-OHdG, were significantly lower in the H 2  group. In conclusion, H 2  dissolved in the ocular irrigating solution protected corneal endothelial cells from phacoemulsification-induced oxidative stress and damage.

Hydrogen prevents corneal endothelial damage in phacoemulsification cataract surgery