Trabeculectomy with the use of sodium hyaluronate. A prospective study.

The effect of sodium hyaluronate (Healon) on the post-operative course and IOP 1 week and 1 month after trabeculectomy is reported. Twenty-nine eyes of 23 patients with open-angle glaucoma (10 simple, 11 capsular and 8 secondary glaucoma) were operated with the use of sodium hyaluronate. The study was prospective. For comparison, 29 eyes of 21 age- and sex-matched patients with glaucoma, operated during the pre-Healon period were selected. Patients in the study group were operated by the same surgeon and in the control group by different senior staff members. The method for trabeculectomy is described. IOP decrease was 56 and 54% in the H- and control group. No differences in post-operative pressure level existed between the different types of glaucoma. Shallow or flat chamber occurred frequently in both groups, but had a greater incidence in the control group. Sodium hyaluronate seems to prevent early excessive filtration. In five eyes of both groups choroidal detachment was simultaneously present. The incidence of choroidal detachment was the same as the overall incidence of this complication in this clinic. Post-operative pressure rise of greater than 30 mmHg after restoration of a flat chamber was more frequent in the control series. Sodium hyaluronate is useful in trabeculectomy. It prevents collapse of the anterior chamber and hyphema during the operation, it stabilizes early post-operative pressure and prevents excessive filtration combined with shallow or flat anterior chamber. It does not prevent choroidal detachment after trabeculectomy.