Descemet's membrane detachment by sodium hyaluronate.

The inadvertent injection of sodium hyaluronate (Healon) just anterior to Descemet's membrane during an extracapsular cataract extraction resulted in a corneal opacity. No extraordinary measures were taken to remove this substance. The opacity resolved over five months, with a final visual acuity of 20/25 and a reduction in specular microscopic cell density from 2,600 to 2,100/sq mm. Sodium hyaluronate was injected in an analogous manner into eight rabbit corneas. The eyes were enucleated, and histologic sections were examined 1, 5, 9, and 14 days later. Sodium hyaluronate injected just anterior to Descemet's membrane was found to incite an acute mild granulocytic response, which is followed by a macrophage invasion and ingestion of this substance. We recommend a conservative approach when the central portion of Descemet's membrane is detached by sodium hyaluronate during anterior segment surgery.

[1]  B. Björkstén,et al.  Effect of hyaluronic acid on polymorphonuclear leucocyte cell surface properties. , 2009, Scandinavian journal of haematology.

[2]  J. Sugar,et al.  Stripping of Descemet's membrane associated with intraocular lens implantation. , 1983, Archives of ophthalmology.

[3]  P. Berkowitz.  Surgical wound leaks associated with sodium hyaluronate (Healon). , 1983, American journal of ophthalmology.

[4]  S. M. Mac Rae,et al.  The effects of sodium hyaluronate, chondroitin sulfate, and methylcellulose on the corneal endothelium and intraocular pressure. , 1983, American journal of ophthalmology-glaucoma.

[5]  S. Percival.  Complications from use of sodium hyaluronate (Healonid) in anterior segment surgery. , 1982, The British journal of ophthalmology.

[6]  E. de Juan,et al.  Sodium hyaluronate and tissue adhesive in treating corneal perforations. , 1982, Ophthalmology.

[7]  F. Polack,et al.  Sodium hyaluronate (Healon) in keratoplasty and IOL implantation. , 1981, Ophthalmology.

[8]  E. Balazs,et al.  The use of sodium hyaluronate (Healon) in human anterior segment surgery. , 1980, Ophthalmology.

[9]  E. Balazs,et al.  Replacement of the liquid vitreus with sodium hyaluronate in monkeys. I. Short-term evaluation. , 1980, Experimental eye research.

[10]  M. Sears,et al.  Distribution of acid phosphatase, beta-glucuronidase, and lysosomal hyaluronidase in the anterior segment of the rabbit eye. , 1978, Investigative ophthalmology & visual science.

[11]  D. Metzler,et al.  Biochemistry: The Chemical Reactions of Living Cells , 1977 .

[12]  B. Toole,et al.  Hyaluronate production and removal during corneal development in the chick. , 1971, Developmental biology.

[13]  A. Nesburn,et al.  Combined use of sodium hyaluronate and tissue adhesive in penetrating keratoplasty of corneal perforations. , 1984, Ophthalmic surgery.

[14]  A. W. Richter,et al.  Non-immunogenicity of a purified sodium hyaluronate preparation in man. , 1979, International archives of allergy and applied immunology.

[15]  R. Praus,et al.  Glycosaminoglycans in Embryonic and Postnatal Human Cornea , 1975 .

[16]  W. Richter.  Non-immunogenicity of purified hyaluronic acid preparations tested by passive cutaneous anaphylaxis. , 1974, International archives of allergy and applied immunology.

[17]  R. Praus,et al.  Glycosaminoglycans in the Developing Chicken Cornea , 1971 .