It will be difficult to find an ophthalmic surgeon who will gladly
do his work entirely without viscoelastics. Within just a few years
this group of substances has enlarged the field of ophthalmic
surgery enormously. Many procedures have be come safer and simpler
and other techniques could only be developed because of the
availability of visco elastics. Especially cataract surgery and
implantation of intraocular lenses have benefitted. Implantation of
an intraocular lens can be per formed much more reliably into the
capsular bag without endangering the posterior capsule.
Implantation of foldable lenses would be almost impossible without
visco elastics. However, other surgical maneuvers also necessitate
visco elastics, especially when the anterior chamber must be
maintained, the corneal endothelium must be protected and delicate
tissues must be manipulated. A cor neal transplant can be sutured
safely into the recipient corneal ring using visco elastics. Even
in glaucoma surgery, visco elastics gain importance as they are
being used in trabeculectomy or in deep sclerectomy with additional
viscocana lostomy. But which substance is best for which purpose?
Just as much as a basic phar macological knowledge is necessary for
a rational use of drugs, in-depth know ledge of physicochemical
properties and objective investigations are prerequi sites for a
logical selection of visco elastics from an ever increasing number
of available substances. H.
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