The use of viscoelastics transformed cataract surgery decades ago. We use the viscoelastic to protect delicate tissues like the corneal endothelium and also to maintain space such as when performing a capsulorhexis or inserting the IOL. There is a wide spectrum of viscoelastics though we tend to divide them into two general categories: dispersive and cohesive.
Dispersive is like honey – it coats because it’s more liquid. Cohesive is like gelatin – holds space because it’s more solid.
In order to classify viscoelastics as devices instead of drugs, the name OVD (ophthalmic visco-surgical device) was introduced about a decade ago. There are important techniques that you must learn with OVDs such as the viscoelastic wave, the soft-shell technique, and even the angle sweep to avoid retained material.
At the end of your cataract surgery case, make sure that you are removing all of the OVD. This angle sweep technique will help you avoid retained OVD and high IOP in the post-op period.
Professor Uday Devgan MD is a Los Angeles Cataract Surgeon who authors CataractCoach.com to teach the best techniques of Cataract Surgery to Eye Surgeons from around the world.
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