New ophthalmic dual-viscoelastic device in cataract surgery: a comparative study

Abstract

ObjectiveTo compare the performance and safety in cataract surgery of two ophthalmic viscoelastic devices (OVDs), each having separate dispersive and cohesive characteristics and different concentrations.Methods and analysisIn this prospective, randomised, controlled clinical study, one eye of each patient was injected with OVD1 (Viscopack14) or OVD2 (DuoVisc) during phacoemulsification and intraocular lens implantation. Endothelial cell count, intraocular pressure (IOP), central corneal thickness (CCT), intraocular inflammation and corrected distance visual acuity (CDVA) were compared 3 months postoperatively.ResultsThe study enrolled 127 patients. Randomisation assigned 50 eyes of as many patients to each arm of the study. The postoperative mean endothelial cell loss was 14.4% and 7.1% from baseline in the OVD1 and OVD2 groups, respectively (p=0.08). The incidence of IOP spikes at 2 hours was 0% and 8%, respectively (p=0.02). There were intergroup differences in postoperative IOP values, the OVD2 group showed significantly higher values at all of the follow-up visits starting from the 24 hours examination (p<0.05). There was no statistically significant difference in the CCT, intraocular inflammation and CDVA at the end of follow-up.ConclusionBoth OVDs showed similar clinical performances and were equally effective during cataract surgery. Viscopack14 showed more corneal endothelial cell reduction, while DuoVisc had more occurrences of IOP values and spikes. Future studies are mandatory to support these preliminary results.

Diluting 2.5% Viscoadaptive Sodium Hyaluronate to Prevent Postoperative Intraocular Pressure Rise After Phacoemulsification: A Pilot Study

“…Total removal of the viscoelastic device is a critical step post-IOL insertion in phacoemulsification. If OVD stays in the anterior chamber or behind the IOL, it can cause complications, including a rise in IOP, pain, and corneal endothelial loss [ 8 ]. Implantation of IOL with OVD dilution was never reported in the literature.…”

“…Viscoelastic agents have diverse viscosity, concentration, and molecular size that can affect their elimination with irrigation, aspiration, and outflow via trabecular meshwork [ 3 , 7 ]. IOP rise can be prevented via numerous methodologies such as using a low molecular weight viscoelastic agent, avoiding overfilling the anterior chamber with viscoelastic intraoperatively, and ensuring the removal of all viscoelastic material via irrigation and aspiration at the end of surgery [ 8 , 9 ]. As such, the primary concern is that viscoelastic agents can remain behind the intraocular lens (IOL) during surgery, which makes it critical to be removed, predisposing to IOP spikes [ 3 , 10 , 11 ].…”

Viscoelasticity of Liposomal Dispersions

“…Thus, the viscoelastic behaviour of a pharmaceutical dosage form may contribute to its better tolerability. Since several body fluids—as mentioned above—exhibit viscoelastic behavior, this type of rheological property is particularly important, e.g., in the formulation of ophthalmic products [ 1 , 2 ], intraarticular preparations [ 3 , 4 ] and dermal fillers [ 5 , 6 , 7 ].…”