Viscoelastic protection from endothelial damage by air bubbles

Abstract

Viscoat effectively protected the endothelium from air-bubble damage. Viscoat appears to protect the endothelium by acting as a physical barrier. Its adherence is probably related to the way it interacts with the mucinous layer of the endothelium.

Early changes in corneal edema following torsional phacoemulsification using anterior segment optical coherence tomography and Scheimpflug photography

“…In this study, the density of corneal endothelial cells decreased following cataract surgery when compared with the preoperative numbers in both groups. In previous studies, to analyze the degree of corneal damage following phacoemulsification, the number and density of corneal endothelial cells in a 1 mm 2 area were measured using specular microscopy [16][17][18][19]; however, specular microscopy can only evaluate a small part of the corneal endothelial injury and is therefore insufficient for ascertaining changes in the entire cornea and morphological changes at the incision point. Therefore, based on the central corneal thickness and specular microscopy alone, the data needed for determining the degree of corneal edema following phacoemulsification are insufficient.…”

Role of cavitation in the phacoemulsification process

“…Endothelial cell loss after phacoemulsification surgery is well documented. 6,7 Corneal endothelial damage during phacoemulsification is attributed to several factors including excessive duration of phacoemulsification, [8][9][10] localized temperature increase, 11 contact or collision of lens nucleus fragments after turbulent flow of irrigation solution, 12,13 air bubbles, 14,15 and surgical skills. 16 It has also been shown that the generation of free radicals during phacoemulsification can cause adverse effects on the cellular and subcellular levels through diverse mechanisms, one of which is acoustic cavitation.…”

Alteration of free radical development by ophthalmic viscosurgical devices in phacoemulsification

“…Corneal endothelium damage in phacoemulsification is caused by several factors including excessive duration of phacoemulsification, 1-3 localized temperature increase, 4 contact or collision of lens nucleus fragments following the turbulent flow of the irrigation solution, 5,6 or air bubbles. 7,8 Although it is not widely recognized, another harmful factor associated with the use of ultrasound (US) is the development of free radicals. Free radicals can cause oxidative damage to endothelial cells, and their presence may be 1 of the most damaging events during these procedures.…”