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RESEARCH PRODUCT

General Applications of Viscoelastics

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The many and diverse physicochemical characteristics of viscoelastic substances impose both their desired and undesired effects clinically. As there is no single ideal substance to meet clinical stipulations, individual viscoelastic characteristics should be considered with respect to demand. Georg Eisner described viscoelastic agents as a tool for space-occupying measures (in tissues, in space or on surfaces) applied by the use of special techniques (Eisner, 1980; Eisner, 1983). In surgery, viscoelastic substances protect tissues and cells from mechanical trauma, serve to separate tissues, occupy space, break away adhesions, stop bleeding, coat, act as manipulative instruments and move tissues back and forth. Furthermore, they maintain space postoperatively for a certain amount of time and can reduce local bleeding. Side-effects are noted as well. As opposed to pure fluids, viscoelastic substances do not spread out throughout the entire intraocular space, but rather remain mostly around the area of injection. Since viscoelastic substances consume space, it follows that they require adequate space or compressible tissue might be displaced. Possible consequences include, for example, further radial tearing and rupture of the posterior lens capsule, lesions in the zonula or iris and lastly, lens or implant luxation.