Removal times for a dispersive and a cohesive ophthalmic viscosurgical device correlated with intraocular lens material.
OBJECTIVE
To investigate the removal times of ophthalmic viscosurgical devices (OVDs) with different intraocular lens (IOL) designs and materials.


METHODS
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.
Auffarth
Gerd U
GU
Heidelberg IOL & Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. gerd_auffarth@med.uni-heidelberg.de
Holzer
Mike P
MP
Visessook
Nithi
N
Apple
David J
DJ
Völcker
Hans E
HE
D000180:Acrylic Resins; D001672:Biocompatible Materials; D002807:Chondroitin; D002809:Chondroitin Sulfates; D004322:Drainage / Q000379:methods*; D004338:Drug Combinations; D006801:Humans; D006820:Hyaluronic Acid; D007431:Intraoperative Complications / Q000517:prevention & control; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications / Q000517:prevention & control; D012826:Silicone Elastomers; D013997:Time Factors
D000180:Acrylic Resins; D001672:Biocompatible Materials; D004338:Drug Combinations; D012826:Silicone Elastomers; C501944:chondroitin sulfate, sodium hyaluronate drug combination; D006820:Hyaluronic Acid; D002807:Chondroitin; D002809:Chondroitin Sulfates; D019904:Polymethyl Methacrylate