{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:23:08Z","timestamp":1787775788104,"version":"build-2784847793"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To explain the physical properties of ophthalmic viscoelastic devices (OVDs), covering their structural units, optimal features, existing viscoelastic materials, clinical applications, and potential side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a narrative review on the OVDs. A literature review was conducted in PubMed, Google Scholar, and Scopus databases. Studies that investigated physical characteristics, clinical applications, OVD commercial products, and their complications were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 42 articles from 2010 and discussed physical characteristics, properties of a desirable OVD, structural units of common OVDs, OVD commercial products, clinical applications, and also complications of OVDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Today, viscoelastics hold a distinct and crucial role in intraocular surgery due to their remarkable properties. These materials safeguard the endothelium and epithelium, uphold anterior chamber depth, manage intraocular bleeding, ease tissue handling, and aid intraocular lens placement. Currently, the American market features 12 prevalent viscoelastic types, including 7 sodium hyaluronate derivatives (Healon, Healon-Greater Viscosity, Healon-5, Amvisc, Amvisc Plus, Advanced Medical Optics Vitrax, and Provisc), 2 hydroxypropyl methylcellulose 2% derivatives (OcuCoat and Cellugel), and 3 combinations of sodium hyaluronate and chondroitin sulfate (Viscoat, DisCoVisc, and DuoVisc). Despite the introduction of new viscoelastic materials annually, no single material encompasses all desired properties. Surgeons must select and employ suitable viscoelastics based on surgical conditions and patient requirements. Advancements in material development and understanding of physical properties and clinical applications continue to refine viscoelastic selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joco.joco_178_23","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T15:57:46Z","timestamp":1725983866000},"page":"313-319","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Physical Characteristics, Clinical Application, and Side Effects of Viscoelastics in Ophthalmology"],"prefix":"10.4103","volume":"35","author":[{"given":"Mehrdad","family":"Mohammadpour","sequence":"first","affiliation":[{"name":"Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Asadigandomani","sequence":"additional","affiliation":[{"name":"Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran"},{"name":"Department of Ophthalmology, School of Medicine, Tehran University of Medical Science, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Aminizade","sequence":"additional","affiliation":[{"name":"Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Raeisi","sequence":"additional","affiliation":[{"name":"Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,8,10]]},"reference":[{"key":"R1-20240910","first-page":"7801093","article-title":"Impact of ophthalmic viscosurgical devices in cataract surgery","author":"Malvankar-Mehta","year":"2020","journal-title":"J Ophthalmol 2020"},{"key":"R2-20240910","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0886-3350(00)00568-X","article-title":"Effect of healon5 and 4 other viscoelastic substances on intraocular pressure and endothelium after cataract surgery","volume":"27","author":"Holzer","year":"2001","journal-title":"J Cataract Refract Surg"},{"key":"R3-20240910","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0886-3350(01)01262-7","article-title":"Intraocular pressure after bilateral cataract surgery using healon, healon5, and healon GV","volume":"28","author":"Arshinoff","year":"2002","journal-title":"J Cataract Refract Surg"},{"key":"R4-20240910","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1248\/cpb.c18-00890","article-title":"Rheological and adhesive properties to identify cohesive and dispersive ophthalmic viscosurgical devices","volume":"67","author":"Watanabe","year":"2019","journal-title":"Chem Pharm Bull (Tokyo)"},{"key":"R5-20240910","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.21608\/amj.2021.196377","article-title":"Comparison of intraocular lens implantation with and without viscoelastic substances in phacoemulsification","volume":"50","author":"Mohamed","year":"2021","journal-title":"Al-Azhar Med J"},{"key":"R7-20240910","doi-asserted-by":"crossref","first-page":"22","DOI":"10.29228\/targetmedj.67507","article-title":"Field of Use Hyaluronic Acid and its Derivatives","volume":"2","author":"Is\u0131k","year":"2023","journal-title":"International Target Medicine Journal"},{"key":"R8-20240910","first-page":"293","article-title":"Evaluation of the rheological properties, preclinical safety, and clinical effectiveness of a new dispersive ophthalmic viscoelastic device for cataract surgery","volume":"15","author":"Palacio-Pastrana","year":"2022","journal-title":"Med Devices (Auckl)"},{"key":"R9-20240910","doi-asserted-by":"crossref","first-page":"3791","DOI":"10.4103\/ijo.IJO_1048_22","article-title":"Corneal endothelial protection during manual small-incision cataract surgery: A narrative review","volume":"70","author":"Singh","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"R11-20240910","first-page":"16","article-title":"Comparative physical properties of ophthalmic viscoelastic materials","volume":"7","author":"Arshinoff","year":"1989","journal-title":"Ophthalmic Pract"},{"key":"R12-20240910","doi-asserted-by":"crossref","first-page":"555","DOI":"10.4103\/jdmimsu.jdmimsu_239_20","article-title":"Comparative study of safety and efficacy of dispersive versus cohesive ophthalmic viscosurgical devices in cataract surgery after phacoemulsification","volume":"15","author":"Kalode","year":"2020","journal-title":"J Datta Meghe Inst Med Sci Univ"},{"key":"R13-20240910","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s10792-016-0211-x","article-title":"Intraocular lens implantation without the use of ophthalmic viscosurgical device","volume":"37","author":"Unsal","year":"2017","journal-title":"Int Ophthalmol"},{"key":"R14-20240910","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/ICU.0b013e3282f14db0","article-title":"Ophthalmic viscosurgical devices","volume":"19","author":"Bissen-Miyajima","year":"2008","journal-title":"Curr Opin Ophthalmol"},{"key":"R15-20240910","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s40123-021-00403-9","article-title":"Ophthalmic viscosurgical devices (OVDs) in challenging cases: A review","volume":"10","author":"Borkenstein","year":"2021","journal-title":"Ophthalmol Ther"},{"key":"R16-20240910","doi-asserted-by":"crossref","first-page":"117697","DOI":"10.1016\/j.carbpol.2021.117697","article-title":"Hyaluronan and its derivatives for ophthalmology: Recent advances and future perspectives","volume":"259","author":"Huerta","year":"2021","journal-title":"Carbohydr Polym"},{"key":"R18-20240910","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/0014-4835(80)90092-5","article-title":"Replacement of the liquid vitreus with sodium hyaluronate in monkeys. I. Short-term evaluation","volume":"31","author":"Denlinger","year":"1980","journal-title":"Exp Eye Res"},{"key":"R19-20240910","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/S0886-3350(86)80087-6","article-title":"Is 2% hydroxypropylmethylcellulose a safe solution for intraoperative clinical applications?","volume":"12","author":"Rosen","year":"1986","journal-title":"J Cataract Refract Surg"},{"key":"R21-20240910","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/0014-4835(80)90093-7","article-title":"Replacement of the liquid vitreus with sodium hyaluronate in monkeys. II. Long-term evaluation","volume":"31","author":"Denlinger","year":"1980","journal-title":"Exp Eye Res"},{"key":"R22-20240910","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S0886-3350(13)80341-0","article-title":"Corneal endothelial and intraocular pressure changes after phacoemulsification with amvisc plus and viscoat","volume":"19","author":"Probst","year":"1993","journal-title":"J Cataract Refract Surg"},{"key":"R23-20240910","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1097\/j.jcrs.0000000000001201","article-title":"Safety and effectiveness comparison of a new cohesive ophthalmic viscosurgical device","volume":"49","author":"Packer","year":"2023","journal-title":"J Cataract Refract Surg"},{"key":"R24-20240910","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1097\/j.jcrs.0000000000000904","article-title":"Safety and effectiveness of a new ophthalmic viscosurgical device: Randomized, controlled study","volume":"48","author":"Packer","year":"2022","journal-title":"J Cataract Refract Surg"},{"key":"R25-20240910","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/S0002-9394(14)73923-6","article-title":"A comparison of corneal endothelial changes after use of Healon or Viscoat during phacoemulsification","volume":"115","author":"Koch","year":"1993","journal-title":"Am J Ophthalmol"},{"key":"R26-20240910","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1016\/j.jcrs.2005.08.056","article-title":"New classification of ophthalmic viscosurgical devices \u2013 2005","volume":"31","author":"Arshinoff","year":"2005","journal-title":"J Cataract Refract Surg"},{"key":"R27-20240910","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1136\/bjo.2005.085969","article-title":"Retention and removal of a new viscous dispersive ophthalmic viscosurgical device during cataract surgery in animal eyes","volume":"90","author":"Oshika","year":"2006","journal-title":"Br J Ophthalmol"},{"key":"R28-20240910","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.jcrs.2006.02.039","article-title":"In vitro behavior of ophthalmic viscosurgical devices during phacoemulsification","volume":"32","author":"Bissen-Miyajima","year":"2006","journal-title":"J Cataract Refract Surg"},{"key":"R29-20240910","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/S0886-3350(96)80199-4","article-title":"Comparison of the effect of four viscoelastic agents on early postoperative intraocular pressure","volume":"22","author":"Henry","year":"1996","journal-title":"J Cataract Refract Surg"},{"key":"R30-20240910","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1016\/j.jcrs.2007.06.039","article-title":"Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification","volume":"33","author":"Shingleton","year":"2007","journal-title":"J Cataract Refract Surg"},{"key":"R31-20240910","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s10384-013-0274-4","article-title":"Postoperative flat anterior chamber: Incidence, risk factors, and effect on the long-term success of trabeculectomy","volume":"57","author":"Ono","year":"2013","journal-title":"Jpn J Ophthalmol"},{"key":"R32-20240910","first-page":"950","article-title":"Management of hypotony and flat anterior chamber associated with glaucoma filtration surgery","volume":"8","author":"Tun\u00e7","year":"2015","journal-title":"Int J Ophthalmol"},{"key":"R33-20240910","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/IJG.0b013e31816f7647","article-title":"The early flat anterior chamber after trabeculectomy: A randomized, prospective study of 3 methods of management","volume":"18","author":"de Barros","year":"2009","journal-title":"J Glaucoma"},{"key":"R34-20240910","first-page":"819","article-title":"Use of sodium hyaluronate in reformation and reconstruction of the persistent flat anterior chamber in the presence of severe hypotony","volume":"13","author":"Fisher","year":"1982","journal-title":"Ophthalmic Surg"},{"key":"R35-20240910","first-page":"1781","article-title":"Ophthalmic viscoelastic device injection for the treatment of flat anterior chamber after trabeculectomy: A case series study","volume":"7","author":"Hosoda","year":"2013","journal-title":"Clin Ophthalmol"},{"key":"R36-20240910","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3928\/1542-8877-20050701-05","article-title":"Effect of intraoperative intracameral 2% hydroxypropyl methylcellulose viscoelastic during trabeculectomy","volume":"36","author":"Agarwal","year":"2005","journal-title":"Ophthalmic Surg Lasers Imaging"},{"key":"R37-20240910","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3390\/jfb4010006","article-title":"Use of an ophthalmic viscosurgical device for experimental retinal detachment in rabbit eyes","volume":"4","author":"Hirata","year":"2013","journal-title":"J Funct Biomater"},{"key":"R38-20240910","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s00417-015-3256-z","article-title":"A cross-linked hyaluronic acid hydrogel (healaflow(\u00ae)) as a novel vitreous substitute","volume":"254","author":"Barth","year":"2016","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R39-20240910","doi-asserted-by":"crossref","first-page":"914675","DOI":"10.3389\/fbioe.2022.914675","article-title":"Biocompatibility and efficacy of a linearly cross-linked sodium hyaluronic acid hydrogel as a retinal patch in rhegmatogenous retinal detachment repairment","volume":"10","author":"Zheng","year":"2022","journal-title":"Front Bioeng Biotechnol"},{"key":"R40-20240910","doi-asserted-by":"crossref","first-page":"e0172895","DOI":"10.1371\/journal.pone.0172895","article-title":"Efficacy of two different thiol-modified crosslinked hyaluronate formulations as vitreous replacement compared to silicone oil in a model of retinal detachment","volume":"12","author":"Schnichels","year":"2017","journal-title":"PLoS One"},{"key":"R41-20240910","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/0002-9394(85)90497-0","article-title":"Comparison of the effects of Viscoat and Healon on postoperative intraocular pressure","volume":"100","author":"Barron","year":"1985","journal-title":"Am J Ophthalmol"},{"key":"R42-20240910","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1080\/08820538.2019.1640750","article-title":"Postoperative Capsular Bag Distension Syndrome-Risk Factors and Treatment","volume":"34","author":"Kanclerz","year":"2019","journal-title":"Semin Ophthalmol"}],"container-title":["Journal of Current Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_178_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:42:06Z","timestamp":1787773326000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_178_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/joco.joco_178_23","relation":{},"ISSN":["2452-2325"],"issn-type":[{"value":"2452-2325","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2023-08-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}