Trabeculectomy with the use of sodium hyaluronate

Abstract The effect of sodium hyaluronate (Healon) on the post‐operative course 1 week, 1 month and 1 year after trabeculectomy is reported. Forty‐six eyes of 38 patients with open‐angle glaucoma (16 simple, 16 capsular and 14 secondary glaucomas) were operated with the use of sodium hyaluronate. The study was prospective. For comparison, 46 eyes of 38 age‐, sex‐and diagnosis‐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. IOP decrease was essentially the same in both groups. No differences in post‐operative pressure level existed between the different types of glaucoma. Extremely shallow or flat chamber occurred more frequently in the control series: 15 versus 9. Statistical analysis could not be applied. The trend in favour of Healon is discussed. Pressure rise ≥ 30 ramHg 2–7 days after the operation was diagnosed in 8 eyes of the Healon group and 13 eyes of the control group. IOP rise was relieved by argon laser treatment of the fistula during the first week post‐operatively in 6/8 eyes of the Healon group in order to facilitate aqueous drainage. Sodium hyaluronate facilitated the technical performance and prevented collapse of anterior chamber and AC haemorrhages during the operation. Sodium hyaluronate seems to prevent excessive early filtration and hypotony. After follow‐up of one year, 7 patients in the control series and 4 in Healon series had progression of cataract. Two of the patients in the control‐group needed cataract operation during the follow‐up period. A definite conclusion in favour of Healon has to be verified.