New ophthalmic dual-viscoelastic device in cataract surgery: a comparative study

Area of Science:

• Ophthalmology
• Surgical Innovation
• Biomaterials Science

Background:

• Ophthalmic viscoelastic devices (OVDs) are crucial for maintaining anterior chamber space during cataract surgery.
• Different OVDs possess varying cohesive and dispersive properties, impacting surgical outcomes and safety.
• Understanding the comparative performance of OVDs with distinct characteristics is essential for optimizing surgical techniques.

Purpose of the Study:

• To compare the clinical performance and safety of two distinct ophthalmic viscoelastic devices (OVDs) during cataract surgery.
• To evaluate the impact of Viscopack14 and DuoVisc on key postoperative parameters including endothelial cell count, intraocular pressure (IOP), and visual acuity.
• To determine if differences in OVD properties translate to significant clinical outcomes in patients undergoing phacoemulsification and intraocular lens implantation.

Main Methods:

• A prospective, randomized, controlled clinical study involving 127 patients undergoing cataract surgery.
• Each patient received either OVD1 (Viscopack14) or OVD2 (DuoVisc) during phacoemulsification and intraocular lens implantation.
• Postoperative outcomes including endothelial cell count, IOP, central corneal thickness (CCT), intraocular inflammation, and corrected distance visual acuity (CDVA) were assessed at 3 months.

Main Results:

• Postoperative mean endothelial cell loss was 14.4% for OVD1 and 7.1% for OVD2 (p=0.08).
• The incidence of IOP spikes at 2 hours was 0% for OVD1 and 8% for OVD2 (p=0.02).
• OVD2 group showed significantly higher postoperative IOP values from 24 hours onwards (p<0.05), with no significant differences in CCT, inflammation, or CDVA.

Conclusions:

• Both OVDs demonstrated comparable clinical performance and effectiveness in cataract surgery.
• Viscopack14 was associated with greater corneal endothelial cell reduction compared to DuoVisc.
• DuoVisc exhibited a higher incidence of intraocular pressure (IOP) values and spikes, necessitating further investigation.