Removal times for a dispersive and a cohesive ophthalmic viscosurgical device correlated with intraocular lens material

Auffarth, Gerd U.; Holzer, Mike P.; Visessook, Nithi; Apple, David J.; Völcker, Hans E.

doi:10.1016/j.jcrs.2004.03.039

« Previous Next »Journal of Cataract & Refractive Surgery
Volume 30, Issue 11 , Pages 2410-2414, November 2004

Removal times for a dispersive and a cohesive ophthalmic viscosurgical device correlated with intraocular lens material☆

Gerd U. Auffarth, MD
- Reprint requests to Gerd U. Auffarth, MD, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
- Heidelberg IOL & Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
Mike P. Holzer, MD
- Heidelberg IOL & Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
Nithi Visessook, MD
- Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA
David J. Apple, MD
- Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA
Hans E. Völcker, MD
- Heidelberg IOL & Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany

Accepted 16 March 2004.

Abstract

Purpose: To investigate the removal times of ophthalmic viscosurgical devices (OVDs) with different intraocular lens (IOL) designs and materials.

Setting: Center for Research on Ocular Therapeutics and Biodevices, Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Heidelberg IOL & Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.

Methods: In a standardized laboratory setup, the Miyake-Apple posterior view video technique was used to evaluate OVD removal from capsular bags in human autopsy eyes implanted with poly(methyl methacrylate) (PMMA), silicone, and acrylic IOLs. The cohesive OVD ProVisc® (sodium hyaluronate 1.0%) and the dispersive OVD Viscoat® (sodium hyaluronate 3.0% and chondroitin sulfate 4.0%) were stained with fluorescein for better visualization. The open-sky preparation and an Alcon Series 20000® Legacy® phaco machine with a flow rate of 25 mL/min and a vacuum setting of +500 mm Hg (maximum irrigation/aspiration) were used. The time needed for complete removal of the cohesive and dispersive OVDs with each IOL type was measured and analyzed statistically.

Results: The mean removal times for both OVDs were as follows: Alcon MZ60BD PMMA IOL—25.0 seconds ± 3.7 (SD) (Viscoat), 15.9 ± 6.9 seconds (ProVisc); Alcon AcrySof® MA60BM IOL—35.5 ± 10.0 seconds (Viscoat), 25.6 ± 4.7 seconds (ProVisc); Chiron/Bausch & Lomb C1043 silicone IOL—46.5 ± 10.5 seconds (Viscoat), 17.3 ± 2.1 seconds (ProVisc); AMO SI-30 silicone IOL—33.5 ± 3.1 seconds (Viscoat), 15.3 ± 6.3 seconds (ProVisc); and Pharmacia 912 silicone IOL—18.3 ± 5.8 seconds (Viscoat), 19.8 ± 4.3 seconds (ProVisc).

Conclusions: Differences in OVD removal times were detected. The removal time for the cohesive OVD correlated with the IOL material. Overall, the time needed for complete removal was significantly longer for the dispersive OVD than for the cohesive OVD.