Adjunctive viscoelastic therapy for postoperative ciliary block

Following Molteno device implantation, trabeculectomy, or needling revision of trabeculectomy, six eyes of six chronic glaucoma patients developed a flat anterior chamber without hypotony, ciliochoroidal detachment, pupillary block, or external wound leak. The ciliary block did not respond to vigorous medical and laser therapy. We performed an intracameral injection of sodium hyaluronate, which resulted in maintenance of a full anterior chamber and normal intraocular pressure in all of the six eyes. The use of intracameral viscoelastic appears to be a reasonable adjunct for management of ciliary block not responsive to vigorous medical therapy and intracameral air injection trial, before attempting more extensive surgery.