Rotational Stability of a Single-Piece Hydrophobic Acrylic Intraocular Lens During Removal of Ophthalmic Viscosurgical Devices

PURPOSE: To compare the effect of cohesive and dispersive ophthalmic viscosurgical device (OVD) on intraoperative rotational stability of the intraocular lens (IOL) with single-piece hydrophobic acrylate platform. DESIGN: Prospective, comparative study. METHODS: This institutional clinical study included 60 eyes of 60 patients who underwent phacoemulsifcation. The patients were equally divided into cohesive OVD (Healon GV; Abbott Medical Optics, Abbott Park, Illinois, USA) group and dispersive OVD (Viscoat; Alcon Laboratories, Fort Worth, Texas, USA) group. Image analysis from the captured digital image was used to measure intraoperative rotation of single-piece hydrophobic acrylate IOL (SA60AT or SA60NT) during OVD removal. RESULTS: Mean intraoperative rotation was 7.42 degrees +/- 4.16 (standard deviation) in dispersive OVD group and 13.08 degrees +/- 5.25 (standard deviation) in cohesive OVD group (P < .001). Twenty-one cases (70%) maintained the alignment within 10 degrees during removal of OVD with dispersive OVD, while only 9 cases (30%) did so with cohesive OVD (P = .005). Counterclockwise rotation was observed in 33% of the all cases. CONCLUSIONS: This study showed that a significant amount of IOL rotation occurred during OVD removal. Intraoperative rotational stability of IOL was greater with Viscoat than with Healon GV. (Am J Ophthalmol 2010; 149:253-257. (C) 2010 by Elsevier Inc. All rights reserved.)