Ophthalmic viscosurgical devices are designed to facilitate safety and control during phacoemulsification. But not all OVDs are created equal...
Ophthalmic viscosurgical devices are designed to facilitate safety and control during phacoemulsification. But not all OVDs are created equal, and when combined with different surgical techniques and phacoemulsification settings, their cohesive, dispersive or hybrid properties have a significant impact on the ease with which the surgery is accomplished, as well, as its outcome.
For instance, we have found in my practice that the characteristics of Healon5® (2.3% sodium hyaluronate, Abbott Medical Optics), offer advanced endothelial protection, excellent visualization and superior maintenance of the anterior chamber. We confirmed these observations in a small randomized prospective study.
Study: Healon5 vs. DisCoVisc
Again, OVDs aim to bring enhanced safety and control to cataract surgery; and safety and control are the meat and potatoes of any surgical procedure. When choosing an OVD, a surgeon should ask, "What does this tool bring to the table?" OVD protection depends on two principal factors: its adhesiveness, which allows the OVD to cover the tissue that needs to be protected; and its rigidity; which enables the OVD to act as a shield between the phaco tip and the tissue that requires protection. Healon5 is extremely rigid and protects the endothelium as described in the second scenario, but to take full advantage of this capability we use low phaco parameters to avoid removing it with the solution flow in the anterior chamber.
In conclusion, if we had to choose a single OVD for all cataract surgeries we would opt for Healon5 because of its superior behavior in most steps of cataract surgery due to its viscoadaptative properties.