Intravitreal sodium hyaluronate and secondary glaucoma after complicated phacoemulsification.
We report 4 cases that presented with intractable glaucoma after complicated phacoemulsification during which sodium hyaluronate 1.0% (Healon) was used to tamponade a central posterior capsule rupture. The postoperative intraocular pressure (IOP) was uncontrolled on maximal medical therapy. In 2 patients, the IOP took 8 to 10 weeks to resolve and simultaneous ultrasound B-scans showed the presence of clear globules in the anterior and midvitreous that became smaller with conservative therapy. An early pars plana vitrectomy in 2 cases immediately controlled the IOP. The presence of globules presumed to be sodium hyaluronate in the vitreous cavity of the patients while the IOP was elevated suggests a causal relationship with the refractory secondary glaucoma.
Sihota
Ramanjit
R
Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. rjsihota@hotmail.com
Saxena
Rohit
R
Agarwal
Harish Chandra
HC
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004655:Emulsions; D005260:Female; D005901:Glaucoma / Q000139:chemically induced* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000293:injuries* / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012421:Rupture; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology
D000959:Antihypertensive Agents; D004655:Emulsions; D006820:Hyaluronic Acid