Effect of intraoperative intracameral 2% hydroxypropyl methylcellulose viscoelastic during trabeculectomy.
OBJECTIVE
To evaluate the effect of intraoperative intracameral injection of 2% hydroxypropyl methylcellulose (HPMC) on anterior chamber depth and intraocular pressure (IOP) following trabeculectomy in eyes with uncontrolled primary open-angle glaucoma in a prospective randomized manner.


METHODS
Thirty consecutive eyes with primary open-angle glaucoma scheduled for trabeculectomy were randomized to conventional trabeculectomy without HPMC injection (group I; n = 15) or to intracameral injection of 2% HPMC during trabeculectomy (group II; n = 15). All patients were observed serially on days 1, 3, 5, 7, and 14 and months 1, 3, and 6 postoperatively. The main outcome measure was restoration of anterior chamber depth to preoperative level with IOP of less than 21 mm Hg with no additional antiglaucoma medication or surgery.


RESULTS
The anterior chamber depth decreased from 2.5 +/- 0.53 to 1.5 +/- 0.94 mm on postoperative day 1 in group I and increased slightly from 2.4 +/- 0.43 to 2.5 +/- 0.36 mm on postoperative day 1 in group II (P = .04). Overall, the IOP decreased to 5.0 +/- 2.8 mm Hg in group I (87% reduction) and 9.0 +/- 4.6 mm Hg in group II (70% reduction). Two eyes developed postoperative flat anterior chamber and related complications in group I, whereas none of the eyes in group II developed such complications.


CONCLUSIONS
Intracameral injection of 2% HPMC during trabeculectomy helps to maintain anterior chamber depth and reduces incidence of complications related to shallow anterior chamber depth following trabeculectomy.
Agarwal
Harish C
HC
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All-India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Anuradha
V K
VK
Titiyal
J S
JS
Gupta
Viney
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000187:drug effects*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D065347:Hypromellose Derivatives; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D007430:Intraoperative Care; D008297:Male; D008747:Methylcellulose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D011183:Postoperative Complications; D011446:Prospective Studies; D014130:Trabeculectomy / Q000379:methods*
D009883:Ophthalmic Solutions; D065347:Hypromellose Derivatives; D008747:Methylcellulose