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Published on: September 11, 2013
Descemet's membrane detachment by sodium hyaluronate
Archives of Ophthalmology (Chicago, Ill. : 1960)
|June 1, 1985
Summary
Inadvertent sodium hyaluronate injection near Descemet's membrane caused temporary corneal opacity. The opacity resolved naturally over five months, indicating a conservative approach is recommended for such surgical events.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ocular Histology
Background:
- Sodium hyaluronate (Healon) is commonly used in cataract surgery.
- Accidental injection anterior to Descemet's membrane can occur.
- Understanding the ocular response to misplaced sodium hyaluronate is crucial.
Observation:
- A patient developed corneal opacity after sodium hyaluronate injection during cataract surgery.
- The opacity resolved spontaneously within five months, with visual acuity improving to 20/25.
- Specular microscopy showed a decrease in corneal endothelial cell density.
Findings:
- Animal models (rabbits) demonstrated an acute granulocytic response followed by macrophage infiltration and phagocytosis of sodium hyaluronate.
- Histologic examination confirmed the inflammatory and phagocytic processes.
- The substance was gradually cleared from the anterior chamber.
Implications:
- A conservative, non-interventionist approach is suggested for managing sodium hyaluronate misplaced anterior to Descemet's membrane.
- This approach allows for natural resolution and minimizes iatrogenic damage.
- Further research may explore optimal management strategies for similar surgical complications.
