In vitro behavior of ophthalmic viscosurgical devices during phacoemulsification

Bissen-Miyajima, Hiroko

doi:10.1016/j.jcrs.2006.02.039

Cited by 49 publications

(64 citation statements)

References 11 publications

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“…It has been shown that Viscoat requires a much longer time to be aspirated. 5,16,17 As shown in the results of the present series, the surgeons found that DisCoVisc removal could be done by rapid fragmentation with an irrigation/ aspiration tip. In addition, DisCoVisc did not require behind the lens technique for the washout.…”

Section: Discussionsupporting

confidence: 69%

“…In another study, DisCoVisc showed superior retention as compared with Viscoat, which had earlier been reported to have the best retention time. 5 Tognetto and co-authors, in their clinical trial, documented OVD retention during phacoemulsification. In another experimental study, a quantitative assessment of OVD retention was carried out using in vivo confocal microscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Different types of OVDs have been developed and their behaviour inside the eye has been evaluated. [1][2][3][4][5] With the introduction of the soft shell technique, 6 the differences between cohesive and dispersive OVDs were characterized and the OVDs were used at the appropriate phase of emulsification for protecting the corneal endothelium and maintaining space. The cohesive high molecular weight OVDs help sustain the anterior chamber during phacoemulsification.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] Recently, new viscous dispersive OVDs have been developed. DisCoVisc 5,12 is a viscoelastic solution of sodium chondroitin sulfate and sodium hyaluronate with a viscosity of 75 000 (SD 35 000) millib Pascal seconds (mPas) at a shear rate of 1 s À1 and 251C. It has been claimed that DisCoVisc has an intermediate cohesive/dispersive index, which facilitates both space maintenance and tissue protection.…”

Section: Introductionmentioning

confidence: 99%

“…It has been claimed that DisCoVisc has an intermediate cohesive/dispersive index, which facilitates both space maintenance and tissue protection. 5,12 In a previous randomized clinical trial, 13 we evaluated the postoperative outcomes in patients with uncomplicated age-related cataract undergoing phacoemulsification using DisCoVisc as against the soft shell technique. In this study, we showed that DisCoVisc is an effective OVD comparable with Viscoat and Provisc in its postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Subjective evaluation of intraoperative performance of DisCoVisc in complex ocular environments

Praveen

Vasavada

Koul

et al. 2010

Eye

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Purpose To subjectively evaluate the intraoperative characteristics of DisCoVisc during phacoemulsification in complex ocular environments. Patients and methods In this prospective observational study, two experienced surgeons (ARV and CZ) performed phacoemulsification on 100 consecutive patients with cataract associated with complex ocular environments. Inclusion criteria were eyes with shallow anterior chambers (anterior chamber depth (ACD) of o2.1 mm), inadequate pupillary dilation (3 mm), dense cataract, and white mature cataract. The surgeons subjectively assessed the endpoints at each phase of phacoemulsification and various behavioural aspects of the ophthalmic viscosurgical devices (OVDs) were subsequently evaluated. Results The distribution was as follows: eyes with white mature cataract (n ¼ 18), eyes with grades 4 and5 cataract (n ¼ 56), eyes with co-existing shallow ACD o2 mm (n ¼ 24), and co-existing small pupil size o2 mm (n ¼ 18). DisCoVisc behaved like a moderately cohesive viscoelastic in 94% of the cases. Injection of viscoelastic was easy in 38 (38%) eyes and very easy in 62 (62%) eyes. Visualization after the viscoelastic injection was excellent in 74% of the eyes. During phacoemulsification, DisCoVisc was moderately dispersive at all the stages of emulsification. The bag maintenance during IOL implantation was excellent in 56% eyes; IOL implantation was easy in 26% of the eyes and difficult in 20% of the eyes. Surgeons found viscoelastic removal easy in 68% of the eyes. At the time of OVD removal, DisCoVisc behaved like both a dispersive and a cohesive viscoelastic in 96% of the eyes.Conclusion DisCoVisc provides both cohesive and dispersive properties. DisCoVisc alone, even in complex ocular environments, enabled the surgeon to achieve good intraoperative performance.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subjective evaluation of intraoperative performance of DisCoVisc in complex ocular environments

Praveen

Vasavada

Koul

et al. 2010

Eye

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Influence of Elevated Intraocular Pressure on the Posterior Chamber–Anterior Hyaloid Membrane Barrier During Cataract Operations

Kawasaki

Tasaka²,

Suzuki³

et al. 2011

Arch Ophthalmol

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To investigate the influence of elevated intraocular pressure on the posterior chamber-anterior hyaloid membrane (PC-AHM) barrier during cataract operations in ex vivo porcine eyes. Methods: A pressure transducer was connected to porcine eye anterior chambers (ACs). In experiment 1, ACs were perfused for 20 seconds with balanced salt solution containing 1.0-µm fluorescein beads (10 eyes per bottle height: 45, 85, 145, and 285 cm). In experiment 2, 5 ophthalmic viscosurgical devices with different molecular weights and sodium hyaluronate concentrations were infused into the ACs (20 eyes per ophthalmic viscosurgical device). After continuous curvilinear capsulorrhexis, hydrodissection was performed. After both experiments, PC-AHM barrier staining was evaluated through the Miyake-Apple view. Results: Types of fluorescein staining patterns were classified as AC, zonule of Zinn, AHM, AHM tear, and ruptured capsule. In experiment 1, plateau intraocular pressure and staining type were positively correlated (Spearman rank correlation; r=0.703, P Ͻ.001). In experiment 2, mean peak intraocular pressure was significantly greater in the ruptured capsule-type eyes than in the AC-, zonule of Zinn-, AHM (P Ͻ .001), or AHMtear-(P=.02) type eyes, as well as in the AHM-and AHMtear-type eyes compared with the AC and zonule of Zinn type eyes (P Ͻ .001). Intraocular pressure was significantly higher in eyes infused with ophthalmic viscosurgical devices with a higher molecular weight or sodium hyaluronate concentration (P Ͻ.05). Conclusions: Stress on the PC-AHM barrier increases as intraocular pressure increases. Ophthalmic viscosurgical devices with a higher molecular weight or sodium hyaluronate concentration might induce increased IOP during cataract operations. Clinical Relevance: To maintain normal PC-AHM barrier function, excessive intraocular pressure should be avoided during cataract operations.

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Residual amounts of ophthalmic viscosurgical devices on the corneal endothelium following phacoemulsification

2009

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In vitro behavior of ophthalmic viscosurgical devices during phacoemulsification

Cited by 49 publications

References 11 publications

Subjective evaluation of intraoperative performance of DisCoVisc in complex ocular environments

Subjective evaluation of intraoperative performance of DisCoVisc in complex ocular environments

Influence of Elevated Intraocular Pressure on the Posterior Chamber–Anterior Hyaloid Membrane Barrier During Cataract Operations

Residual amounts of ophthalmic viscosurgical devices on the corneal endothelium following phacoemulsification

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