In vitro behavior of ophthalmic viscosurgical devices during phacoemulsification.

摘要

PURPOSE: To evaluate the behavior and aspiration of several ophthalmic viscosurgical devices (OVDs) during phacoemulsification. SETTING: Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan. METHODS: Cohesive OVDs (sodium hyaluronate 1.0% [Healon and Provisc]), dispersive OVDs (sodium hyaluronate 3.0%-chondroitin sulfate 4.0% [Viscoat]), and new-generation OVDs such as viscoadaptive (sodium hyaluronate 2.3% [Healon5]) and viscodispersive (hyaluronic acid 1.65%-chondroitin sulfate 4.0% [DisCoVisc]) OVDs, were stained with fluorescein sodium. The movement of the OVDs during simulated cataract surgery was recorded in porcine eyes under an operating microscope and with a side-view video camera. The initial and complete aspiration times of each OVD during phacoemulsification using 20 and 40 mL/min flow rates and sleeves and the removal times using the irrigation and aspiration (I/A) tip at the end of surgery were evaluated from the recorded videos. RESULTS: The complete aspiration time of the cohesive OVDs was less than 3 seconds but up to 20 seconds with a low flow rate of 20 mL/min with a smaller sleeve. Other OVDs remained in the anterior chamber during phacoemulsification with both flow rates. The removal time for cohesive OVDs was less than 4 seconds and for new-generation OVDs, 10 to 15 seconds. The dispersive OVD required a significantly (P<.05) longer removal time than other OVDs. CONCLUSIONS: Cohesive OVDs are removed easily during phacoemulsification; however, the aspiration rate can be affected by fluidics. New-generation OVDs, such as Healon5 and DisCoVisc, remained in the anterior chamber during phacoemulsification and were removed easily by I/A at the end of surgery. The behavior of these OVDs is preferable during phacoemulsification.