Use of viscoelastics post-trabeculectomy: a survey of members of the American Glaucoma Society.
OBJECTIVE
American Glaucoma Society members were surveyed to determine the pattern of use of viscoelastics for anterior chamber reformation at the slit-lamp in the post-operative clinical management of patients who have undergone trabeculectomy in order to give ophthalmologists an indication of how these materials are being used by their colleagues.


METHODS
We surveyed 196 members of the American Glaucoma Society regarding the following; (1) whether they inject viscoelastic post-operatively at the slit-lamp as an in-office procedure, (2) the type of viscoelastic used most often, (3) the criteria for injection of viscoelastic, (4) the time to first follow-up, (5) the average number of injections, and (6) the occurrence of post-injection endophthalmitis.


RESULTS
One hundred twenty-five (64%) of the 196 mailed surveys were answered and returned. Ninety-four (75%) of the respondents reported injecting viscoelastics in the postoperative period at the slit-lamp as an in-office procedure. Healon (60%) (Pharmacia & Upjohn Co, Kalamazoo, MI), Viscoat (17%) (Alcon, Ft. Worth, TX), and Healon GV (7%) (Pharmacia & Upjohn Co, Kalamazoo, MI) were the three most often used viscoelastics. Hypotony, iriscornea touch, and lens-cornea touch were given as criteria for injection 19%, 47%, and 88% of the time, respectively. Range of time to first follow-up was 1 hour to 7 days, with a mean time of 1 day. Range of average number of injections was 1 to 3 with a mean of 2 injections for patients requiring injection. Only one respondent reported an incidence of endophthalmitis.


CONCLUSIONS
The use of viscoelastic materials in the postoperative trabeculectomy patient in the office at the slit-lamp for anterior chamber reformation is a prevalent practice. Healon is the most commonly used viscoelastic postoperatively and lens-corneal touch is the most common criterion for injection. The average number of injections is 2, with a mean and mode follow-up time of 1 day. Endophthalmitis is a rare complication.
Salvo
E C
EC
Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA.
Luntz
M H
MH
Medow
N B
NB
D000867:Anterior Chamber / Q000033:anatomy & histology; D002807:Chondroitin / Q000627:therapeutic use*; D002809:Chondroitin Sulfates; D004338:Drug Combinations; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007267:Injections; D007429:Intraocular Pressure; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014130:Trabeculectomy / Q000379:methods*; D014481:United States
D004338:Drug Combinations; C501944:chondroitin sulfate, sodium hyaluronate drug combination; D006820:Hyaluronic Acid; D002807:Chondroitin; D002809:Chondroitin Sulfates