<p>Addition Of D-Sorbitol Improves The Usability Of Ophthalmic Viscosurgical Devices</p>

Abstract

PurposeTo evaluate the effects of D-sorbitol addition on changes in the extrusion force of ophthalmic viscosurgical devices (OVDs).MethodsOVD formulations; the mixtures of 3% hyaluronic acid (HA) and 4% chondroitin sulfate (CS) containing 0%, 0.5%, or 1.0% D-sorbitol were prepared. Each prefilled syringe of OVD was stored at room temperature for 0, 15, 30, 60, or 120 mins after a small amount of viscoelastic agent was discharged from the needle. The extrusion force values (kgf) of these OVDs when reused after storage were measured with a texture analyzer. Moreover, 10 healthy adults (5 men and 5 women) used a pinch sensor to measure the extrusion force values for the HA/CS combination without D-sorbitol which was stored in the above manner, and used a 4-step scale to score the usability of OVD.ResultsFor the HA/CS combination without D-sorbitol, the extrusion force value was increased from its initial value (storage duration, 0 min) as storage duration increased. However, for the HA/CS combination containing 0.5% or 1.0% D-sorbitol, this value remained almost unchanged over time. Likewise, the pinch sensor-determined extrusion force values of HA/CS combination without D-sorbitol increased, depending on storage duration.ConclusionThe addition of D-sorbitol to viscoelastic agent may suppress the needle clogging that occurs with OVD storage, and may improve the usability of OVDs during surgery.

Safety and effectiveness of a new ophthalmic viscosurgical device: randomized, controlled study

“…2 Furthermore, sorbitol can help with extrusion of the OVD from the syringe. 8 The ClearVisc syringe includes a larger volume of OVD (1.0 mL) compared with the Viscoat syringe (0.75 mL), resulting in a lower frequency in use of the total syringe volume in the ClearVisc group. The use of a second syringe is associated with an increased cost and delays in the operating room.…”

“…2,9 The scavenging benefits of SH are dependent on the retention of the OVD in the anterior chamber. 1,8,10 In vitro, greater free radical scavenging occurs when the OVD contains more than 1 polymer, which creates a synergistic effect, for example, when an OVD contains both SH and sorbitol. 2 Sorbitol can also improve extrusion force and suppress clogging of the cannula when the same syringe is used repeatedly during surgery.…”

“…2 Sorbitol can also improve extrusion force and suppress clogging of the cannula when the same syringe is used repeatedly during surgery. 8…”

“…2 Sorbitol can also improve extrusion force and suppress clogging of the cannula when the same syringe is used repeatedly during surgery. 8 ClearVisc OVD (SH 2.5%, Bausch & Lomb, Inc.) is a newly approved dispersive OVD. The intended purpose is to protect intraocular tissues during anterior segment surgery.…”

“…Nevertheless, for longer procedures, additional OVD may be needed because OVD may be aspirated from the eye and the protective effect of the OVD agent may be lost. 1,8 Safety concerns typically associated with OVDs include an increase in IOP from retained OVD, inflammatory reactions, toxic anterior segment syndrome, and vision loss associated with increased IOP and inflammation.…”