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    Viscoelastics Alcon

    Uploaded by

    Raquel Wong

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Viscoelastics Alcon

    Uploaded by

    Raquel Wong
    17 views12 pages

    Original Title

    VISCOELASTICS-ALCON

    Copyright

    © © All Rights Reserved

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    PPTX, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    17 views12 pages

    Viscoelastics Alcon

    Uploaded by

    Raquel Wong

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    Ophthalmic

    iscosurgical Devices
    OVD Product Indications
    Indications for Use
    • Create and maintain space
    • Protect corneal endothelium and other
    intraocular tissues
    • Manipulate tissues during surgery
    • Coat IOLs and/or instruments
    • Noted for use in cataract, keratoplasty,
    ocular trauma, glaucoma surgery and/or
    retinal procedures
    Composition of OVDs
    Three primary components:
     Hyaluronic acid (HA)
     Chondroitin sulfate (CS)
     Hydroxypropylmethylcellulose (HPMC)
    • All OVDs are made from one or some of these components

    • Each component contributes specific characteristics


    to the final OVD

    • Hyaluronic acid (HA) is a pseudo-plastic material


    whereas Chondroitin sulfate (CS) is a Newtonian material
    OVD Classification
    • Historically, there were two classes of OVD –
    cohesive and dispersive.
    • The dividing line between cohesive and dispersive
    viscoelastics was established at 1 million Daltons.
    – Greater than 1 million Daltons = Cohesive
    – Less than 1 million Daltons = Dispersive
    Cohesive OVDs
    • Cohesion is the degree to which a
    material adheres to itself.
    • It is generally a function of molecular weight.
    • Higher MW, the longer the molecular chain and the
    more the molecules entangle with each other.
    • Entanglement causes the substance to be easily
    removed in a mass or bolus
    (similar to a plate of sticky spaghetti).
    Cohesive OVDs

    • Long chains entangle Think spaghetti


    with one another
    • High entanglement
    causes the substance to
    move together as a
    mass
    • High pseudoplasticity
    and surface tension
    Dispersive OVDs
    • Low molecular weight
    • Medium to low viscosity at
    low shear
    • HPMC products have the lowest viscosity at all shear
    levels
    • Short molecular chains coat surfaces well, but also
    take longer to remove
    (like macaroni noodles)
    Dispersive OVDs
    • Short chains do not
    entangle Think macaroni
    • Lack of entanglement
    causes the molecules to
    remain separated
    • Low pseudoplasticity and
    surface tension
    • MW < 106 D
    Historical Classification of OVDs
    Highly
    Dispersive 1,000,000 Cohesive Cohesive
    Daltons

    Healon®
    Viscoat ®
    Healon® 5
    Cellugel®
    ProVisc® Healon® GV
    Ocucoat®
    Amvisc®
    OVD Best Uses
    Cohesives Dispersives
    • Create and preserve spaces; • Selectively move
    displace and stabilize tissues and isolate tissues

    • Low protection factor due to • Very protective of corneal


    ease of aspiration endothelium throughout lens
    removal
    • Clear visualization
    • Less clear visualization
    • Most are easy to remove
    • More difficult to remove
    DuoVisc
    • One vial of Viscoat (.5ml) • One vial of Provisc (.55ml)
    •3% HA (Sodium Hyaluronate) & 4% CDS • 1% HA (Sodium Hyaluronate)
    (Chondroitin Sulfate) • Creates and preserves space under low
    • Triple negative charge due to CDS shear rate
    • Very protective of the corneal endothelium • Used to inflate the capsular bag prior to
    IOL implantation
    • Excellent retention in the eye
    • Easy to remove from the bag following
    • Selectively moves and isolates tissue
    lens insertion
    • More difficult to remove from the eye following surgery

    DuoVisc give you the best of all worlds:


    • Viscoat used for endothelial cell protection at the
    beginning of the case
    • Provisc used for inflation of the capsular bag at the
    end of the case, prior to IOL insertion
    1 2

    Soft
    Shell
    Technique*

    3 4

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