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Abstract #5919 Published in IGR 2-1
Coinjection of hyaluronic acid and hyaluronidase (letter)
Schwartz DM; Equi R; Jumper MArchives of Ophthalmology 2000; 118: 445
In this correspondence, the authors comment on a paper by Haroony et al. on the co-injection of hyaluronic acid (HA) and hyaluronidase. The original authors claim that the pressure-lowering effects of hyaluronidase in the presence of intracameral hyaluronic acid are related to the degradation of sodium HA, rather than to native trabecular sodium HA molecules. The corresponding authors agree with this. They also state that IOP elevation, after intracameral injection of HA, is related to the molecular weight, and hence to the viscosity of the HA molecules injected. The preparation of intraocular hyaluronidase was Wydase. The corresponding authors feel that the side-effects of this preparation are due to impurities. When they used a more purified preparation they found it be 100 times less toxic. A second author, Paul Fechner from Germany, reports on his experience with hyaluronidase in 65 eyes. The main point made by this author is that he has seen no side-effects from this preparation and that, on the first postoperative, day the mean intraocular pressure was 16 mmHg. He particularly points out that he has been no retinal detachments. In theory, hyaluronidase could trigger retinal detachment if it seeped into the vitreous cavity and dissolved the HA of the vitreous body. This did not happen. The interesting observation made in this correspondence is that the use of hyaluronidase may reduce the pressure peaks after Healon. If the appropriate preparation is used.
Classification:
12.20 Other (Part of: 12 Surgical treatment)