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Why are Ophthalmic Viscosurgical Devices irreplaceable in eye surgery? Do you understand the science behind them?
In ophthalmic surgery, Ophthalmic Viscosurgical Devices (OVDs) play an irreplaceable role. This clear, gel-like substance is used to maintain the volume and shape of the anterior chamber of the eye and protect intraocular tissues during surgery. Although many new technologies are emerging, OVDs remain an important tool in this field. This article will explore the importance of OVDs and the science behind them, and further consider why they cannot be replaced.
Originally known as viscoelastic materials, OVDs have a consistency that allows surgical tools to move freely between them.
Uses and functions of OVDs
OVDs are widely used in various ophthalmic surgeries, including cataract surgery, corneal surgery, glaucoma surgery, ocular trauma and vitreoretinal surgery. Their primary role is to protect the corneal endothelium from mechanical trauma and to maintain the volume and shape of the intraocular space during an open incision. OVDs are introduced into the anterior chamber of the eye via a syringe through a catheter and at the end of the procedure are removed by a suction device and the space is filled with a compatible fluid such as buffered saline solution.
OVDs are indispensable in ophthalmic surgery, and despite their side effects, the advantages they bring make them critical surgical aids.
Characteristics and advantages of OVDs
The ideal OVD should have a variety of properties, such as ease of placement, low viscosity, good pressure resistance, and non-interference with the use of surgical instruments. The physical properties of these substances, such as viscoelasticity, viscosity, and surface tension, are important determinants of their use in ophthalmic surgery.
Viscoelasticity refers to the property of a material that displays both viscosity and elasticity when deformed, allowing OVDs to maintain their shape under low shear stress.
Composition and manufacturing of OVDs
OVDs are composed of various viscoelastic compounds and buffers to ensure that the liquid remains sterile in an environment with a pH of 7 to 7.5. The most common ingredients include hyaluronic acid (Sodium hyaluronate), chondroitin sulfate (Chondroitin sulfate) and hydroxypropyl methylcellulose (Hypromellose). The production of these compounds dates back to the 1930s and has undergone numerous improvements and innovations over time.
Since the advent of OVDs in 1972, these products have changed the way eye surgery is performed, significantly improving the safety and effectiveness of surgery.
Contraindications and side effects of OVDs
Despite the obvious advantages of OVDs, they still have some side effects, the most notable of which is excessive postoperative intraocular pressure. This phenomenon usually occurs on the first day after surgery and resolves on its own after a few days. While various medications can be used to limit pressure fluctuations, the effects of these measures are not entirely predictable, making surgeons need to remain vigilant about this potential risk.
The thinking behind the science
The role of OVDs during surgery goes beyond simply occupying a position in physical space. Their biocompatibility, hydrodynamic properties, and support for the surgical process make them tools that cannot be easily replaced. Understanding how this works is crucial for any ophthalmology professional.
The rational use of OVDs can help surgeons provide optimal results in various complex surgical environments.
In general, OVDs undoubtedly play a key role in ophthalmic surgery, performing well in terms of postural stability, visual field clarity, and protection of intraocular tissues. Because of this, as technology develops, we may not be looking for replacements for these devices, but how to further improve and expand their applications?
