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The DuoVisc Viscoelastic System (Alcon) is comprised of VISCOAT OVD, which protects endothelial cells, and ProVisc OVD, which provides anterior capsule dome maintenance and easy removal of the product during surgery.
PROTECTS THE ENDOTHELIUM
I’ve been using DuoVisc since about 2000 and it’s been a wonderful solution. It offers endothelial cell protection, which helps my patients have much clearer corneas on day one.
Prior to using DuoVisc, I would use VISCOAT selectively on patients if I was concerned about their endothelial health. Now that I use DuoVisc on all my patients, I no longer have to worry about that. It stays in place until I want to remove it and protects the cornea for the entire case. If there is a floppy iris or there’s been a breach in the posterior capsule, it’s great for isolating tissues because it stays in place.
For the second phase of the operation, once you’ve removed the cataract and need to re-inflate the capsular bag, ProVisc is a wonderful choice. As the second part of the DuoVisc duo, ProVisc is a cohesive viscoelastic and because of that, once I’ve maintained the space to insert the intraocular lens, it’s easily and completely removed in a matter of seconds. This speeds up the case and leads to greater predictability.
While there are other products that do this same thing, they are either a dispersive viscoelastic that protects the endothelium or they are cohesive and more easily removed after maintaining the space.
But while the competitors are approaching the coating abilities of VISCOAT, none is quite as protective, stable and effective. VISCOAT, which is unique to DuoVisc, is the best product of its kind.
With DuoVisc, you do have to be careful to get all the material out of the eye at the end. But since VISCOAT has a small molecular weight, if you do leave some in the eye, it’s less likely to cause an elevation in intraocular pressure. But the flip side of that is it can be a little more difficult to get out, which could take another few seconds. In an efficient OR, where every second counts, it might be better to have something that does just as good a job but comes out a little quicker.
I do recommend DuoVisc. It’s a mature product in our industry that still does a great job. As the number-one product for endothelial protection, I would recommend that people use VISCOAT at the beginning of the case and for any situations where they need better tissue isolation. And they should use ProVisc wherever they need space maintenance for a brief period of time and easy removal of the product.