Evidence map›Paper›PMID 42163257›Full record

Trial reportBMC ophthalmology2026

Hyaluronic acid concentration predictably modulates physicochemical properties and clinical performance in ophthalmic viscosurgical devices: integrated laboratory and prospective clinical assessment.

Alejandro Melero, Josune Torrecilla, Ander Pino, José María Alonso, Daniel Coello, Sandra Sáez de Arregui, Gonzaga Garay-Aramburu, Silvia López-Plandolit, Olaia Guergué, Iker Henares and 3 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07343973 (Post-Market Study for the Evaluation of the Efficacy and Safety of the OpHLINE Ophthalmic Viscosurgical Device), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07343973 nacompletednot on this map

Post-Market Study for the Evaluation of the Efficacy and Safety of the OpHLINE Ophthalmic Viscosurgical Device (OVD) in Cataract Surgery

TypeinterventionalSponsori+Med S.Coop.Ran2021 to 2022Enrolled69ConditionsCataract SurgeryArmsCataract Surgery by Phacoemulsification with Posterior Chamber Intraocular Lens Implantation (OpHLINE 1.4%), Cataract Surgery by Phacoemulsification with Posterior Chamber Intraocular Lens Implantation (OpHLINE 2%), Cataract Surgery by Phacoemulsification with Posterior Chamber Intraocular Lens Implantation (OpHLINE 3%)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Alejandro Melero *i+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain.
Josune Torrecilla *i+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain.
Ander Pino *i+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain. ander.pino@imasmed.com.
José María Alonsoi+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain.
Daniel CoelloAraba University Hospital, Vitoria-Gasteiz, Spain.
Sandra Sáez de ArreguiAraba University Hospital, Vitoria-Gasteiz, Spain.
Gonzaga Garay-AramburuBiobizkaia Health Research Institute; Osakidetza, Basurto University Hospital, Bilbao, Spain.
Silvia López-PlandolitBiobizkaia Health Research Institute; Osakidetza, Basurto University Hospital, Bilbao, Spain.
Olaia GuerguéBiobizkaia Health Research Institute; Osakidetza, Basurto University Hospital, Bilbao, Spain.
Iker HenaresBiobizkaia Health Research Institute; Osakidetza, Basurto University Hospital, Bilbao, Spain.
Amaia Huguet-Casqueroi+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain.
Miguel Ucelay López de Herediai+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain.
Raúl Pérez Gonzálezi+Med S. Coop, Hermanos Elhuyar, 6, Vitoria-Gasteiz, Spain.

Funding

Basque Country Government (Spain) MTVD20/BCB/024Basque Government's Department of Health - Research Intensification Program 2024222008
6 · The paper itself

Abstract

backgroundOphthalmic viscosurgical devices (OVDs) are essential in cataract surgery for maintaining anterior chamber stability and protecting intraocular tissues. This study evaluated the physicochemical and rheological properties of three hyaluronic acid-based OVDs (OpHLINE

methodsA two-phase investigation was conducted: (1) characterization of OpHLINE formulations versus four commercial comparators, including cohesive-dispersive analysis and viscosity-shear profiling; and (2) a prospective clinical trial in 68 patients undergoing phacoemulsification with intraocular lens implantation. Primary endpoint was workspace maintenance; secondary endpoints included ease of OVD removal, endothelial cell density (ECD) loss, and intraocular pressure (IOP) changes.

resultsBy varying HA concentration at constant molecular weight, we achieved direct control of rheological properties and CDI, generating distinct functional profiles: OpHLINE 1.4% behaved cohesively with rapid aspiration, OpHLINE 3% exhibited dispersive-like retention while maintaining space, and OpHLINE 2% combined cohesive handling with the highest shear-resistant viscosity. Clinically, OpHLINE 2% maintained an intermediate behaviour regarding space maintenance, ease of removal, ECD and IOP, while OpHLINE 3% provided the highest full chamber maintenance during all surgical steps. OpHLINE 1.4% enabled the easiest removal (95% adequate) and the lowest ECD loss (12.9%). IOP spikes ≥ 30 mmHg occurred in 13.6%, 20.8%, and 30.4% of eyes at 6 h for 1.4%, 2%, and 3%, respectively, resolving without sequelae.

conclusionThis study demonstrates that cohesive-dispersive behaviour and shear-dependent viscosity can be predictably tuned by HA concentration alone, enabling a modular, evidence-based approach to OVD selection. OpHLINE series provide evidence for three distinct behaviours: 1.4% showed optimal removal and endothelial protection; 2% offered balanced rheological and clinical properties; 3% provided the most consistent anterior chamber stability during surgery. These results allow surgeons to tailor intraoperative performance without altering polymer chain length.

trial registrationThis study was retrospectively registered (OpHLINE-PIC01-2020), approved on 8 February 2021 by the Ethics Committee for Research with Medicines of Euskadi (CEIm-E, Spain, code PS2020065).

trial registrationClinicalTrials.gov, NCT ID Number NCT07343973, Registered on 07 January 2026.

Indexed as

Hyaluronic AcidLens Implantation, IntraocularPhacoemulsificationViscosupplementsAgedFemaleHumansIntraocular PressureMaleMiddle AgedProspective StudiesRheologyViscosityHyaluronic AcidViscosupplementsCataract surgeryCohesive–dispersive indexHyaluronic acidOphthalmic viscosurgical deviceRheology

Identifiers

PMID42163257
PMCPMC13371008

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.