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Purpose: To determine whether there is a difference in frequency or severity of postoperative intraocular pressure (IOP) spikes after bilateral phacoemulsification with complete ophthalmic viscosurgical device (OVD) removal when Healon5 (sodium hyaluronate 2.3%), Healon (sodium hyaluronate 1%), or Healon GV (sodium hyaluronate 1.4%) is used., Setting: York Finch Eye Associates and Humber River Regional Hospital, Toronto, Ontario, Canada., Methods: Bilateral cataract surgery was performed in 99 patients; 50 were randomly assigned to receive Healon5 in 1 eye and Healon GV in the fellow eye and 49, Healon in 1 eye and Healon GV in the fellow eye. The IOP was measured preoperatively as well as 5 and 24 hours and 7 days postoperatively. The mean IOP and standard deviation at each time interval were calculated for each OVD. The results were compared among the OVDs using Student t tests for each time at which IOP was assessed., Results: There were no significant differences in postoperative IOP spikes among the Healon5, Healon, and Healon GV groups; however, patients receiving lower viscosity OVDs had a lower mean IOP at 24 hours. All groups had increased IOP at 5 and 24 hours and reduced IOP at 7 days., Conclusions: Within a family of molecularly similar OVDs, lower viscosity OVDs appear to cause slightly lower mean elevations in IOP in normal patients at 24 hours. However, if the OVD is removed, postoperative IOP spikes above 21 mm Hg appear related more to patient factors (eg, predisposition in glaucoma patients) and surgically induced trauma than to the specific long-chain non-cross-linked hyaluronan OVD used.