Document Detail

Relationship between postoperative intraocular pressure elevation and residual sodium hyaluronate following phacoemulsification and aspiration.
MedLine Citation:
PMID:  9113583     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To investigate the relationship between postoperative intraocular pressure (IOP) elevation and the amount and viscosity of sodium hyaluronate remaining in the anterior chamber after phacoemulsification and aspiration (PEA). SETTING: Hachioji Medical Center and Tokyo Medical College Hospital, Tokyo, Japan. METHODS: In 107 eyes, washout (irrigation and aspiration [I/A]) of sodium hyaluronate was performed for randomly assigned durations of 5, 10, or 20 seconds following PEA and intraocular lens (IOL) implantation. At the conclusion of washout, the flow from the I/A tip was reversed and a sample of the irrigating solution obtained from the anterior chamber. The residual sodium hyaluronate concentration was measured by sandwich assay. The kinematic viscosity of the sample was calculated from a regression equation derived from measured viscosities of standard hyaluronate solutions of various concentrations. RESULTS: The preoperative mean IOP in the groups that received 5-, 10-, and 20-second washout was 11.9, 10.9, and 11.6 mm Hg, respectively. The mean IOP on the first postoperative day in the 5-second group was significantly higher (P = .001, Kruskal-Wallis test) than those in the 10- and 20-second groups (10.8 and 11.6 mm Hg, respectively). A significant correlation was observed between residual hyaluronate concentration and IOP on the first postoperative day (Spearman's rank correlation coefficient 0.319, n = 80, P = .045) and also between kinematic viscosity and IOP on the first postoperative day (one-factor analysis of variance, P < .001). CONCLUSION: The sodium-hyaluronate-induced IOP elevation is related to its viscosity as well as to its high molecular weight. Washout times of at least 10 seconds are desirable to prevent IOP elevation.
T Tanaka; H Inoue; S Kudo; T Ogawa
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  23     ISSN:  0886-3350     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-06-27     Completed Date:  1997-06-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  284-8     Citation Subset:  IM    
Department of Ophthalmology, Tokyo Medical College Hospital, Japan.
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MeSH Terms
Aged, 80 and over
Anterior Chamber / drug effects
Hyaluronic Acid / administration & dosage,  adverse effects*,  analysis
Intraocular Pressure*
Lenses, Intraocular
Middle Aged
Molecular Weight
Ocular Hypertension / chemically induced*,  physiopathology
Phacoemulsification / methods*
Postoperative Period
Reg. No./Substance:
9004-61-9/Hyaluronic Acid

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