New classification of ophthalmic viscosurgical devices—2005

Arshinoff, Steve A.; Jafari, Masoud

doi:10.1016/j.jcrs.2005.08.056

Cited by 85 publications

(105 citation statements)

References 3 publications

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“…7 A previous experimental study showed that the retention and removal properties of DisCoVisc fell between cohesive Provisc and dispersive Viscoat, and DisCoVisc was retained in the AC during phacoemulsification better than Healon5, whereas removal of DisCoVisc with the I/A tip was easier than Healon5. 9 We obtained similar results in the current clinical study.…”

Section: Discussionmentioning

confidence: 95%

“…6 Recently, a new class of OVD, DisCoVisc, has been developed and introduced in the market. 7 DisCoVisc is a viscoelastic solution of sodium chondroitin sulphate and sodium hyaluronate, having a viscosity of 75 000 ± 35 000 milliPascal-seconds (mPas) at a shear rate of 1/s and 25 1C. Each millilitre of DisCoVisc contains not more than 40 mg sodium chondroitin sulphate and 17 mg sodium hyaluronate.…”

Section: Introductionmentioning

confidence: 99%

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Prospective randomized comparison of DisCoVisc and Healon5 in phacoemulsification and intraocular lens implantation

Oshika

Bissen-Miyajima

Fujita

et al. 2010

Eye

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Purpose To compare two ophthalmic viscosurgical devices (OVDs), DisCoVisc (viscous dispersive) and Healon5 (viscoadaptive), in terms of their overall clinical performance during phacoemulsification and intraocular lens (IOL) implantation. Methods In 323 patients (DisCoVisc; 157, Healon5; 166), the surgeons evaluated on a three-point scale, the maintenance of anterior chamber (AC) during continuous curvilinear capsulorhexis (CCC), maintenance of AC during IOL implantation, retention during phacoemulsification, ease of injection, facilitation of CCC, transparency during surgery, and ease of removal from the eye. The time needed to completely remove OVDs after IOL implantation was measured. Masked examiners measured intraocular pressure (IOP), corneal thickness, and corneal endothelial cell count up to 90 days postoperatively. Results DisCoVisc was assessed to be significantly better than Healon5 in maintenance of AC during CCC (P ¼ 0.0008, Cochran-Mantel-Haenszel test) and IOL implantation (P ¼ 0.0055), retention during phacoemulsification (P ¼ 0.0009), ease of injection (Po0.0001), facilitation of CCC (Po0.0001), transparency (Po0.0001), and ease of removal (Po0.0001). The washout time was 29.6 ± 13.4 and 36.2 ± 17.5 s in the DisCoVisc and Healon5 groups, respectively (P ¼ 0.0002, unpaired t-test). The mean endothelial cell loss was 1.8 ± 8.7% in the DisCoVisc group and 3.8±8.3% in the Healon5 group (P ¼ 0.0358).There were no statistically significant between-group differences in IOP and corneal thickness. Conclusion DisCoVisc was better retained in the eye during phacoemulsification and was easier to remove after IOL implantation. The corneal endothelial cell loss was significantly less with DisCoVisc than with Healon5. It was indicated that the whole surgical process can be efficiently covered by DisCoVisc alone.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Prospective randomized comparison of DisCoVisc and Healon5 in phacoemulsification and intraocular lens implantation

Oshika

Bissen-Miyajima

Fujita

et al. 2010

Eye

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“…According to Arshinoff's classification, sodium hyaluronate 2.3%, known as Healon 5, is a pseudodispersive substance which allows relatively useful iris dilation and a stable anterior chamber in terms of reduced phacoemulsification parameters (aspiration rate below 22 ml/min and vacuum below 200 mmHg) [17,18].…”

Section: Introductionmentioning

confidence: 99%

Correlation between urological alpha1-AR antagonist medication and changed intraoperative iris behavior

Horváth

Vultur

2011

Int Ophthalmol

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The aim of our study was to report on the incidence, the etiology and the management of intraoperative floppy iris syndrome (IFIS) during phacoemulsification. A non-randomized, observational, prospective study was performed for 1 year, in which 439 eyes of 438 patients (320 men and 118 women) undergoing cataract surgery by the same surgeon were enrolled. The surgeon was blinded to the patients' drug history. The use or non-use of alpha blockers (especially tamsulosin for benign prostatic hyperplasia), duration of the treatment, presence or absence of IFIS, management of IFIS and intraoperative complications were recorded. A 3.2 mm incision was performed on 316 eyes and a 2.4 mm incision on 123 eyes. IFIS occurred in 2.96% of the patients who were taking an alpha1 antagonist. In 5.47% we identified an intraoperative iris behaviour which imitated an incipient IFIS stage called IFI-like syndrome. In cases of insufficiently dilated pupils, diluted intracameral epinephrine as well as irrigation fluid was used. Vertical chop, stability of the anterior chamber by decreasing the corneal wound size, and reducing turbulence into the anterior chamber, enhanced the surgery on eyes with IFIS. There were no intraoperative or postoperative complications. The incidence of IFIS in our study was linked to alpha blocker medication. We postulate that IFIS may be caused by other medication, but this could not be demonstrated statistically. IFIS can be well controlled during surgery, intracameral epinephrine being the main stabilizing factor.

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“…[1][2][3][4] These multiple features enable them to facilitate the steps of intraocular surgery in a controlled manner. Different types of OVDs have been developed and their behaviour inside the eye has been evaluated.…”

Section: Introductionmentioning

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%

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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New classification of ophthalmic viscosurgical devices—2005

Abstract: The surgical behavior of OVDs can be predicted by their position in a classification of OVDs based upon zero-shear viscosity and cohesion.

Cited by 85 publications

References 3 publications

Prospective randomized comparison of DisCoVisc and Healon5 in phacoemulsification and intraocular lens implantation

Prospective randomized comparison of DisCoVisc and Healon5 in phacoemulsification and intraocular lens implantation

Correlation between urological alpha1-AR antagonist medication and changed intraoperative iris behavior

Subjective evaluation of intraoperative performance of DisCoVisc in complex ocular environments

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