ClearVisc is the newest addition to the Bausch + Lomb ophthalmic viscosurgical device (OVD) portfolio, approved by the United States Food and Drug Administration in April of 2021. ClearVisc is a new dispersive viscoelastic that offers excellent chamber stability and endothelial corneal protection. It provides the surgeon with good visualization with more volume eliminating the need to open a second syringe of viscoelastic during cases.

Dr. Mitchell Shultz is board certified and a fellow of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery. Recently, Dr. Shultz had the opportunity to be among the first US surgeons to use ClearVisc. In Dr. Shultz’s experience, “ClearVisc is truly a dispersive viscoelastic. There is viscoelastic still present after phaco protecting the corneal endothelium.” Dr. Shultz described several key advantages of ClearVisc.

ClearVisc Provides a High Level of Free Radical Protection1

ClearVisc contains sodium hyaluronic acid and sorbitol, which has high free radical scavenging activity.1 An in vitro study showed that ClearVisc had greater free radical scavenging activity compared to both Viscoat and Healon.2-3 With the power of sorbitol, ClearVisc provides a dual action to deliver both physical and chemical protection against free radicals during cataract procedures.

In cases where Dr. Shultz would typically see corneal edema and corneal damage, he is experiencing clear corneas day 1 post-op with ClearVisc. ClearVisc limits chemical corneal damage, which can be caused by formation of free radicals during surgery. The protection against free radical activity that ClearVisc provides is a key differentiator. Dr. Shultz noted, “The key to reducing endothelial trauma is reducing oxidative stress to endothelial cells, which can be caused by heat, trauma, or ultrasound. ClearVisc has the capacity to reduce oxidative stress.”

ClearVisc Provides a Clear, Unobstructed View of Tissue and into the Angle

ClearVisc improves tissue visibility during procedures, which is a clear benefit for ophthalmic surgeons. ClearVisc was ranked by surgeons as highest in clarity among other dispersive OVDs by providing a crystal clear, unobstructed view of the tissues and into the angle based on a wet lab survey.3 In fact, in a laboratory study, ClearVisc demonstrated high visible light transmittance.3

In a clinical study of 372 subjects, 100% of eyes that received ClearVisc had clear corneas at one-week post-op.3

When using a dispersive viscoelastic, the surgeon has to be cognizant of whether a fragment of the capsule is lodged in the viscoelastic and needs to be dislodged. ClearVisc’s clarity allows visualization of capsule fragments that may be lodged in the OVD.

Dr. Shultz’s Experience with ClearVisc

ClearVisc stays throughout the whole case and in Dr. Shultz’s experience, “When you are using ClearVisc, you see clear corneas on post-op day 1.”

For traditional cataract surgery, ClearVisc controls the capsule, holds the iris in place, and protects the cornea. In cases where the patient has an opalescent or dense central nucleus, more ultrasonic energy is typically required; thus the necessary additional protection that ClearVisc provides is advantageous.

For surgeons accustomed to dispersive viscoelastics, the transition to ClearVisc will be easy. Dr. Shultz advises that surgeons ensure all of the OVD is removed at the end of the case. While there is very little viscoelastic on the endothelium after phacoemulsification, any that remains should be removed with irrigation/aspiration or displaced with a cohesive viscoelastic before putting in the lens implant; this will help avoid postoperative pressure spikes.

“From a surgeon’s perspective, anything we can do to reduce trauma to the endothelium and maintain corneal clarity is clearly beneficial for our patients.”

– Dr. Mitchell Shultz