Agents for intraocular surgery.

No single viscoelastic material has all the properties required for every surgical procedure. Ophthalmic surgeons should be familiar with the advantages and disadvantages of several viscoelastics and realize the limitations encountered if the surgeon chooses to rely on a single viscoelastic. It is possible in the future that newer viscoelastics may become available offering aspects of cohesive and dispersive properties that make them easy to remove and not associated with postoperative hypertension. Investigation into other types of viscoelastic materials, such as poly-acrylamide (Orcolon) [33,51,52], human collagen [33,53], polytriethylene-glycol monomethacrylate, and polyglycerol monomethacrylate [48], may result in the availability of synthetic viscoelastic materials. Rethinking how we use viscoelastics may also be indicated. The approach of a single or repeat instillation of a viscoelastic only to have it aspirated during the procedure could be modified by using a continuous infusion ofa dilute viscoelastic [54]. One study diluted hyaluronic acid to a concentration of 0.06% to 0.12% and maintained continuous infusion of the viscofluid through the PE irrigation line [54]. It has been suggested that this may reduce turbulence and improve tissue protection [54].