Evaluation of the Protective Effect of an Ophthalmic Viscosurgical Device on the Ocular Surface in Dry Eye Patients during Cataract Surgery

PURPOSE: To evaluate the protective effect of applying an ophthalmic viscosurgical device (OVD) to the ocular surface during cataract surgery and its ability to prevent dry eye syndrome. METHODS: Twenty-four patients aged 50 to 75 years who underwent cataract surgery at Seoul National University Bundang Hospital and agreed to participate in the study were included and divided into two groups: a study group who underwent cataract surgery after application of an OVD to the ocular surface, and a control group who underwent cataract surgery without application of an OVD. DisCoVisc was used as the OVD in the study group, while other factors including surgical techniques and administration of anesthetic agents were performed in both groups in the same manner. Indicators of dry eye syndrome including ocular staining score, tear break-up time, and tear osmolality were analyzed. Ocular surface disease index and a visual analog scale were analyzed for dry eye symptoms, and the amount of balanced salt solution used during surface irrigation and operation time were also analyzed. RESULTS: Significant improvement in the tear break-up time, corneal ocular staining score, and ocular surface disease index score in the study group compared with the control group one week after operation (by the Mann-Whitney test). Use of OVD was associated with longer operating time. CONCLUSIONS: OVD applied to the ocular surface during cataract surgery had a protective effect on the ocular surface one week after surgery.

Comparison of Balanced Salt Solution and Ophthalmic Viscosurgical Device to Maintain Optical Clarity During Phacoemulsification

PURPOSE: To compare the corneal wetting properties of balanced salt solution (BSS) and ophthalmic viscosurgical device (OVD) during cataract surgery. METHODS: The patients with senile cataract were randomly assigned to receive either BSS or viscous dispersive OVD for maintaining optical clarity during phacoemulsification. Intraoperative factors (VAS pain score, occurrence of corneal punctate epithelial erosions (PEE)) and postoperative factors (visual acuity, Oxford staining score, changes in endothelial cell counts, corneal thickness and volume) were compared. RESULTS: Twenty-two eyes were assigned to the BSS group and; 33 eyes were assigned to the OVD group. There were no significant differences in demographic variable between the 2 groups. Intraoperative PEE was observed in 6 eyes in the BSS group and in 2 eyes in the OVD group. The incidence of PEE in the OVD group was significantly lower than in the BSS group (p = 0.045). There were no significant differences in other parameters (VAS pain score, postoperative factors). CONCLUSIONS: Corneal wetting with OVD (Discovisc(R)) provides better surgical view and reduces mechanical damage to the corneal surface without additional material or cost than BSS.

Efficacy and Intraoperative Characteristics of DisCoVisc for Cataract Surgery

PURPOSE: To compare the efficacy and intraoperative characteristics of DisCoVisc with those of Hyal 2000 (sodium hyaluronate 1.0%) in cataract surgery. METHODS: Cataract surgery was performed on 60 eyes in 49 patients who were diagnosed with moderate cataracts. 30 eyes were performed with DisCoVisc and a control group with 30 eyes using Hyal 2000 (sodium hyaluronate 1.0%). Phacodynamics was evaluated including ultrasound (US) time, mean US intensity, cumulative dissipated energy (CDE), and amount of used balanced salt solution. Corneal endothelium and corneal thickness were measured preoperatively and 1 day and 1 month and 2 months postoperatively. RESULTS: There were no statistically significant differences in phacodynamic parameters in the two groups. The central corneal thickness change from preoperatively to postoperatively in the DisCoVisc group was +0.07 +/- 2.44 microm and Hyal 2000 group +0.84 +/- 2.93 microm (p = 0.032) at 2 months. Corneal endothelial cell loss (ECL)(%) at 2 months was 7.67 +/- 8.01% in DisCoVisc group and 13.23 +/- 15.5% in the Hyal 2000 group (p = 0.005). CONCLUSIONS: There was signicant difference between DisCoVisc and Hyal 2000 in the changes of CCT, ECD (Endothelial cell density). (DisCoVisc is effective and provides advantages both cohesive OVDs and dispersive OVDs).

Comparison of OVD and BSS for Maintaining the Anterior Chamber during IOL Implantation

PURPOSE: To compare surgical results between conventional intraocular lens (IOL) implantation using an ophthalmic viscosurgical device (OVD) and IOL implantation using a balanced salt solution (BSS) after irrigation/aspiration (I/A) of the lens cortex. METHODS: A randomized prospective study was conducted on 62 patients who underwent cataract surgery. Following completion of conventional I/A of the lens cortex, we divided patients into two groups according to whether or not BSS was used. In group A (n = 31), the anterior chamber and the capsular bag were completely filled with an OVD before IOL implantation. On the other hand, in group B (n = 31), BSS was irrigated into the anterior chamber through a previous side port during IOL implantation. Surgical results were compared between the two groups. RESULTS: In both groups, IOP peaked six hours after surgery. The occurrence of an IOP spike by postoperative day one was observed in six cases (6 / 31) in group A and in no cases (0 / 31) in group B, a difference that was statistically significant (p = 0.024). The values of endothelial cell density, central corneal thickness, anterior chamber inflammation, myopic shift, and posterior capsule opacification were not significantly different between the two groups. CONCLUSIONS: Compared with the use of OVD for IOL implantation, use of BSS during IOL implantation resulted in reductions in postoperative IOP spike and OVD removal time.