Scheimpflug photography study of ophthalmic viscosurgical devices during simulated cataract surgery

Purpose: To evaluate by Scheimpflug photography the capacity of several commercially available ophthalmic viscosurgical devices (OVDs) to remain in the anterior chamber and maintain anterior chamber depth (ACD) during simulated cataract surgery in porcine cadaver eyes. Setting: Department of Preclinical Ophthalmology, Pharmacia & Upjohn AB, Uppsala, Sweden. Methods: Eighty eyes from newly slaughtered pigs were used. They were distributed equally among 8 OVDs: Amvisc Plus(R) (sodium hyaluronate 1.6%), Biolon (sodium hyaluronate 1.0%), Biolon Prime (sodium hyaluronate 1.2%), Healon(R) (sodium hyaluronate 1.0%), Healon GV(R) (sodium hyaluronate 1.4%), Healon(R)5 (sodium hyaluronate 2.3%), Provisc(R) (sodium hyaluronate 1.0%), and Viscoat(R) (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%). Scheimpflug photographs were taken using a Nidek EAS-1000 instrument before surgery (control), after injection of the OVD, after continuous curvilinear capsulorhexis (CCC), and after lens extraction by phacoemulsification. Differences in the ACD with a P value less than 0.05 were considered statistically significant. The retention capacity was visually assessed. Results: Healon5 had a significantly higher capacity to maintain the ACD than the other OVDs after CCC and phacoemulsification. After injection, Healon5, Viscoat, and Biolon Prime showed similar ACD-maintaining capacities. Conclusion: The capacity of Healon5 to maintain the ACD during cataract surgery, ie, neutralizing the vitreous pressure and stabilizing the anterior segment of the eye, was significantly higher than that of the other OVDs.