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Updated: Jun 21, 2026

In Vitro Investigation of the Effects of the Hyaluronan-Rich Extracellular Matrix on Neural Crest Cell Migration
Published on: February 10, 2023
[Hyaluronidase: Here we go again]
B Etesse1, L Beaudroit, M Deleuze
1Pôle Anesthésie-Douleur-urgences-Réanimation, Groupe Hospitalo-Universitaire Carémeau, 30029 Nîmes cedex 09, France.
Objective:
To summarize the benefits and lateral effects of hyaluronidase (H) use in ophthalmologic anaesthesia and to address its unavailability in current practice in France.
Data Sources:
The Medline data bank and the Cochrane database were consulted. The keywords employed separately or in combination were: H, regional anaesthesia, ophthalmologic surgery, local aneasthetics myotoxicity, diplopia.
Study Selection:
Original articles since 1949 were selected. We also selected isolated clinical cases according to their relevance compared with the existing literature.
Data Synthesis:
H is a "spreading factor" of animal origin used as an adjuvant in ophthalmic anaesthesia for more than half a century. It allows a moderate better block quality with a slightly quicker onset. It also limits the acute intraocular pressure increase secondary to periocular injection and seems to have a protective effect against local anaesthetics myotoxicity resulting in postoperative strabismus. However, during these last 50 years, numerous studies often ended in divergent results.
Conclusion:
H seems to be a useful adjuvant in ophthalmologic anaesthesia in spite of his current unavailability in France. Recombinant H could be the solution in the near future.
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