THE USE OF OPHTHALMIC VISCOSURGICAL DEVICES IN CATARACT SURGERY

In the late 1970's the advent of the intraocular lens and the move from intracapsular to extracapsular cataract extraction and then phacoemulsification caused a dramatic increase in the incidence of postoperative corneal endothelial decompensation, which could only be treated by corneal transplantation.The pioneering work of Endre Balazs and the subsequent licensing of the noninflammatory fraction of hyaluronan to Pharmacia led to the development of ophthalmic viscosurgery using Healon®. Since then numerous other ophthalmic viscosurgical devices have appeared, most of them fitting into a few classes of copies and modified copies of Healon® and Healon®GV, a newer, more viscous variant of Healon®.More recently, a new class of “viscoadaptive agents”, exemplified by Healon®5, has appeared and begun to demonstrate novel applications and advantages.This paper reviews the development of ophthalmic viscosurgery specifically with respect to cataract surgical techniques, and the evolution, uses, classification, advantages and disadvantages of different ophthalmic viscosurgical devices.