The place of sodium hyaluronate in glaucoma surgery

The advantages of sodium hyaluronate (Healon) in filtering surgery have been mostly theoretical, with no study of sufficient numbers to justify its use. The authors used sodium hyaluronate in 119 consecutive trabeculectomies. These were compared to a control group of 122 cases. The long-term intraocular pressure and visual acuity results between the two groups were indistinguishable. The only definite benefit noted with the use of sodium hyaluronate was the lower incidence of hyphemas. No side-effects were seen. Its ability to maintain a deep anterior chamber and encourage hemostasis makes sodium hyaluronate useful in teaching goniotomies as well as performing trabeculectomies in congenital glaucoma. Sodium hyaluronate can also be used to evacuate hyphemas and dissect adhesions with minimal trauma, and may be healthier for the corneal endothelium than air in anterior chamber reformations.