Application of sodium hyaluronate in valve implanation

Objective To evaluate the clinical results of subcojunctival retention of sodium hyaluronic acid or injection of anterior chamber in glaucoma valve implanation for treatment glaucoma and the effectiveness of the surgery and post-operative complications.Methods 34 refractory glaucoma(neovascular glaucoma 26)underwent classical glaucoma valve implanation and vitrectomy,with hyalaronic acid injected undercojunctive flaps when operation was over,Hyalaronic acid in some patients injected into anterior chamber.The changes of IOP,visual acuity,the anterior chamber depth,intraocular irritations and the bleb appearances was observed postoperation.The follow-up was 17.5 months(3～40 months)after surgery.Results The preoperative IOP of patients were(46.4±15.2)mmHg(1mmHg=0.133kPa).The post operative IOP after one week was(8.8±2.4)mmHg,the average IOP was(16.3±8.2)mmHg during follow-up,the decrease rate of IOP was 64.9%.The number of the surgery success was 21 cases,the general success rate was nearly 79.4%(21/34).The preoperative amount of glaucoma medications was average 3.2 comparely,the postoperative amount was 1.3.Visual acuity improved in 3 eyes(8.8%),not change in 30 eyes,reduced in 1 eye.The patients of flat anterior chamber were 5(14.7%) and 2 eyes(5.9%) respectively after one week and 7～10 days,all of the patients with normal anterior chamber after two weeks.Postoperative complicated included anterior chamber hyphema 4 cases(11.8%),the exposure of tube tip 1 case(2.9%) and bleb scarring around the tube tip 7 cases(17.6%).Conclusions Glaucoma setion implanation with subcojunctival retention of hyaluronic acid is benefit to preventing surgery complacation and enhancing the success rate of surgery.