Intraoperative intracameral viscoelastic agent in the prevention of postfiltration flat anterior chamber

A flat anterior chamber after filtration surgery is a serious complication. Intraoperative hypotony with resultant suprachoroidal effusion may be the initial step in the cascade of events leading to this condition. The choroid has a natural elasticity that results in negative pressure in the potential suprachoroidal space when the eye is hypotonous during surgery. To prevent the development of intraoperative hypotony, an intracameral viscoelastic agent (sodium hyaluronate) was used before the filtration surgery. With this technique, only 1 of 60 eyes (1.7%) developed postoperative flat anterior chamber compared with 10 of 60 eyes (16.7%) operated on without the use of an intraoperative intracameral viscoelastic agent. Further evaluation of this technique appears warranted.