New classification of ophthalmic viscosurgical devices—2005

PURPOSE: To revise the generally accepted classification of ophthalmic viscosurgical devices (OVDs) to include cohesion data and the new class of viscous dispersive OVDs. SETTING: York Finch Eye Associates, Toronto, Ontario, Canada, and Alcon Research Limited, Fort Worth, Texas, USA. METHODS: Pseudoplasticity and cohesion-dispersion (CDI) data of DisCoVisc (hyaluronic acid 1.6%-chondroitin sulfate 4%), a new viscous dispersive OVD, were determined and compared with existing OVDs. The existing classification of OVDs was unable to accommodate its properties, so the classification was modified to include a new class and other potential new classes which currently remain unoccupied. RESULTS: Current OVD classification, although based on the clinically significant rheologic parameters of zero-shear viscosity and cohesion, only uses zero-shear viscosity because of the high correlation of these 2 parameters in existing OVDs. The appearance of DisCoVisc forces modification of the existing scheme because it does not fit into a preexisting category. The new proposed broadened classification is changed from a 1-dimensional list into a 2-dimensional table and considers CDI independently from viscosity for all OVDs. Expansion of the classification of OVDs in this manner predicts further possible new innovative OVDs for surgical use. CONCLUSION: The surgical behavior of OVDs can be predicted by their position in a classification of OVDs based upon zero-shear viscosity and cohesion.