Importance of ophthalmic viscoélastique device (OVD) detection in micro-incision cataract surgery

Poster Details

First Author: D.Deidier FRANCE

Co Author(s):                  

Abstract Details

Purpose:

incision size reduction has improved the outcomes of cataract surgery in terms of quality of vision by eliminating induced astigmatism.this was made possible thanks to surgical techniques and technological advances. the importance of OVD selection on safety and ease of surgery was evaluated.

Setting:

Clinique St Vincent Toulon France

Methods:

surgical behavior of various OVDs was tested in BMICS procedures performed with the Stellaris ( Bausch+Lomb) machine through two 1.2mm incisions with 1.7mm enlargement for lens implantation. Endothelial cells loss was compared. Cohesive OVDs such as PhysioVisc Integral (PhysIOL), AmviscPlus(Bausch+Lomb), Zhyalin Plus ( Zeiss) are injected through a thin cannula, do not trap air-bubbles, ensure tissue protection and are easily removed. Dispersive OVDs have better coating properties and are not spontaneously expelled from the anterior chamber during surgical manoeuvres, offering good tissue and space protection.

Results:

better control and safety were provided by cohesive OVDs during capsulorhexis: easy movement, excellent visualisation, capsular flap not pressed against the anterior capsule. During Hydrodissection, no rupture was observed with cohesive OVDs which tend to come out, eliminating the risk of over-pressure. with dispersive OVDs, a small quantity of product had to be aspirated. lens implantation was performed without any risk of over-pressure with cohesive OVDs, a small quantity of product had to be aspirated. lens implantation was performed without any rik of over-pressure with cohesive OVDs as opposed to dispersive OVDs. Endothelial cells count showed no significant differences between OVDs

Conclusions:

Cohesive OVDs were easier to use, provided satisfactory tissue protection and offered sufficient space maintenance in MICS surgery which is performed with less manoeuvres in a more stable and deeper anterior chamber. In this close environement, dispersive OVDs were more difficult to use and presented a risk of over-pressure. FINANCIAL DISCLOSURE?: No