Refractive Changes Induced by Ophthalmic Viscosurgical Devices in Cataract Surgery

To evaluate the refractive changes induced by ophthalmic viscosurgical devices (OVDs) in the anterior chamber after intraocular lens (IOL) implantation using intraoperative aberrometry (IA).

A nonrandomized prospective interventional case series of ten consecutive patients undergoing routine cataract surgery was conducted. Exclusion criteria included previous ocular surgery, corneal opacities, vitreous or macular lesions, and extreme axial lengths. Intraoperative refractive measurements were taken using IA after IOL implantation with cohesive (Provisc, Alcon), intermediate (Vistagel, Johnson & Johnson), and dispersive (Viscoat, Alcon) OVDs. Balanced Salt Solution (BSS) was used as a control. Statistical analysis compared refractive deviations across OVDs.

Provisc, a cohesive OVD, demonstrated the least refractive deviation (median SE -1.0 D) and minimal impact on refractive outcomes. Viscoat, a highly dispersive OVD, induced the greatest refractive deviation (median SE -1.7 D) compared to the control with BSS (median SE -0.1 D). Statistically significant differences in refractive deviations were observed among the tested OVDs compared to BSS (p < 0.05).

This study demonstrates that OVD choice significantly influences refractive outcomes in cataract surgery. Provisc (cohesive) produced the smallest refractive deviation (median SE -1.0 D), whereas Viscoat (dispersive) caused the greatest deviation (median SE -1.7 D) compared with BSS (-0.1 D). These findings underscore the importance of careful OVD selection to optimize refractive precision and highlight the need for further research in diverse surgical settings.