Intracameral 2.3% Sodium Hyaluronate to Treat Postoperative Hypotony in Patients With Glaucoma

BACKGROUND AND OBJECTIVE: To evaluate the intracameral use of Healon5 (2.3% sodium hyaluronate) (Advanced Medical Optics, Santa Ana, CA) in patients with hypotony. PATIENTS AND METHODS: Fifteen consecutive patients with glaucoma who had hypotony for at least 7 days were prospectively recruited. Indications for the intracameral injection of Healon5 were an intraocular pressure (IOP) of less than 6 mm Hg with negative results on Seidel test. RESULTS: The mean IOP readings at baseline, 1 to 2 weeks post-injection, and 4 to 6 weeks post-injection were 3.8 +/- 1.58, 6.58 +/- 2.62, and 6.50 +/- 2.24 mm Hg, respectively. The increase in IOP at both follow-up points was significant (P < .01). The visual acuity improvement was small but significant at the 4 to 6 week point (P = .05). In the early-onset cases, IOP increased significantly from baseline at both follow-up points (P< .05), but visual acuity did not. No significant change from baseline IOP or visual acuity occurred among the late-onset cases. The existing hypotony-related conditions consistently improved by the 4 to 6 week point. CONCLUSIONS: Intracameral injection of Healon5 raised IOP more in early-onset hypotony cases than in late-onset cases. Although the improvements in IOP and visual acuity were statistically significant, the overall clinical picture did not change because the endpoint IOP was still hypotonus. Twenty percent of the patients had IOP spikes that required medical treatment.