Hyaluronidase and sodium hyaluronate in cataract surgery.

Calder, I. G.; Smith, Vernon H.

doi:10.1136/bjo.70.6.418

Cited by 12 publications

(7 citation statements)

References 6 publications

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“…Likewise, the administration of hyaluronidase in the anterior chamber at the end of surgery resulted in lower IOP post-operatively than when the enzyme was not used (Calder & Smith 1986).…”

Section: Discussionmentioning

confidence: 99%

Comparison of sodium hyaluronate and methylcellulose in extracapsular cataract extraction

Thomsen

Simonsen

Andreassen

1987

Acta Ophthalmologica

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Extracapsular cataract surgery with posterior chamber lens implantation was performed in a total of 30 patients. These were randomly divided into two groups. In one group sodium hyaluronate 1% (Healon) was used as a tool in surgery, in the other group methylcellulose 2% was used. The viscous substances were irrigated out of the eyes at the conclusion of surgery. Central corneal thickness, intraocular pressure, and aqueous flare were recorded until one month post-operatively. There was no difference in corneal thickness between the two groups. The mean intraocular pressure was lower than pre-operatively in both groups with a lower pressure in the methylcellulose group compared to the sodium hyaluronate group during the first part of the observation period.

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“…Likewise, the administration of hyaluronidase in the anterior chamber at the end of surgery resulted in lower IOP post-operatively than when the enzyme was not used (Calder & Smith 1986).…”

Section: Discussionmentioning

confidence: 99%

Comparison of sodium hyaluronate and methylcellulose in extracapsular cataract extraction

Thomsen

Simonsen

Andreassen

1987

Acta Ophthalmologica

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“…12 Studies have demonstrated that perfusion of the trabecular meshwork with hyaluronidase results in decreases in intraocular pressure. 9 Our study demonstrates that anterior chamber injections of hyaluronidase alone have only a modest effect in decreasing intraocular pressure.…”

Section: Commentmentioning

confidence: 99%

“…It has been shown that outflow facility is significantly decreased with anterior chamber injections of NaHa, correlating with increases in intraocular pressure. 12 Increased resistance to flow of aqueous humor is thought to occur in the endothelial meshwork, a region with the highest concentrations of NaHa. 3 It is thought that viscoelastic substances bind in this region, where the resistance to aqueous flow is highest, and "clog" the trabecular canals.…”

Section: Commentmentioning

confidence: 99%

“…10 Anterior-and posterior-chamber in-jections in animals as well as humans have strongly suggested that hyaluronidase is well tolerated in small doses. 11,12 The above studies suggest a new method of controlling intraocular pressure by intraoperative injections of hyaluronidase. However, several questions remain to be answered regarding this treatment modality.…”

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confidence: 98%

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Efficacy of Hyaluronidase in Reducing Increases in Intraocular Pressure Related to the Use of Viscoelastic Substances

Harooni

Freilich²,

Abelson³

et al. 1998

Arch Ophthalmol

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To evaluate the efficacy of hyaluronidase in preventing increases in intraocular pressure related to injections of hyaluronan-containing viscoelastic substances.Methods: Twenty-five white rabbits were divided into 5 groups. In groups 1 through 4, 0.15 mL of aqueous humor was removed and replaced with 0.10 mL of a viscoelastic substance in both eyes. Additionally, 10 units of hyaluronidase (0.05 mL) was injected in the anterior chamber of the right eye, whereas the left eye was injected with a volumetrically equivalent dose of balanced saline solution. Viscoelastic substances tested were Healon and Healon GV (Pharmacia & Upjohn, Kalamazoo, Mich), Viscoat (Alcon Laboratories, Fort Worth, Tex), and Ocucoat (Storz Ophthalmics, Clearwater, Fla). In group 5, right eyes were injected with 10 units of hyaluronidase and the left eyes were treated with balanced saline solution.Results: After injections of viscoelastic substance, intraocular pressure rose rapidly, reaching a peak at approximately 46 hours after injection and returning to preinjection levels within 24 hours. Hyaluronidase significantly decreased intraocular pressure when used with Healon, Healon GV, and Viscoat, but not with Ocucoat. When injected in the absence of viscoelastic, hyaluronidase appeared to decrease intraocular pressure, but this result was not statistically significant.Conclusions: Injections of hyaluronidase into the anterior chamber of rabbits effectively prevent increases in intraocular pressure induced by hyaluronan-containing viscoelastic substances. This effect may be related to the ability of hyaluronidase to cleave hyaluronan moieties.

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“…The main function of hyaluronidase is to increase absorption of local anesthetics and enhance sensory anesthesia. The application of hyaluronidase in ophthalmologic surgery is well documented, 1,2 where it has been used for both retrobulbar and periocular anesthesia 3–5 . The drug has also been used in other settings, including acute myocardial infarction and in the resolution of transudates, edema, hematomas, and lumbar disk lesions.…”

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confidence: 99%