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Sylvain Roy, Alexandre Rizatto, Gordana Sunaric-Megevand; Healaflow™ For The Modulation Of Postoperative Healing After Viscocanalostomy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2509.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of a double cross-linked hyaluronic acid on the healing process after viscocanalostomy surgery.
Classical viscocanalostomy (VCS) with injection of Healon GV™ into the Schlemm’s canal (14 eyes) was compared to the same surgical procedure but augmented with injection of Healaflow™ (HF) under the superficial scleral flap (16 eyes). Surgeries were performed between September 2009 and September 2010 in eyes with primary open angle glaucoma (16 cases), pseudoexfoliation glaucoma (12 cases), primary angle closure glaucoma (1 case) and congenital glaucoma (1 case). Main outcomes were: intraocular pressure (IOP), number of antiglaucoma medication, and number of complications.
The mean age for the VCS group was 67.6 ± 9.6 years compared to 75.5 ± 7.7 years in the HF group. The mean follow-up was 16.1 ± 4.4 months in the VSC group and 14.7 ± 3.1 months in the HF group. The mean preoperative IOP was 21.4 ± 5.0 mmHg in the first group and 20.4 ± 3.7 mmHg in the second group, respectively, with a mean number of antiglaucoma medications of 2.7 ± 1.1 (VCS) and 2.6 ± 1.2 (HF), respectively. At final follow-up visits, the mean IOP was 13.6 ± 3.1 mmHg (p<0.05) in the VCS group and 12.6 ± 1.9 mmHg (p<0.05) in the HF group, the mean number of antiglaucoma medication being 0.6 ± 0.7 (VCS) (p<0.005) and 0.3 ± 0.6 (HF) (p<0.005), respectively. Eleven Nd:YAG goniopuncture was performed on 7 eyes in the VCS group and 3 on 3 eyes in the HF group. Two iris incarcerations were recorded in the VCS group whereas no complications occurred in the HF group. One eye required needling of the scleral flap in the VSC group. One eye required further surgical revision of the filtering site from the same VCS group. Complete and overall success rates were 57% and 93%, respectively, in the VCS group, while rates were 81% and 99%, respectively, in the HF group.
Healaflow™, a slow resorbable highly crosslinked sodium hyaluronate drainage implant, prevents postoperative fibrosis and maintains the intrascleral space created with VCS, improving aqueous humour outflow from the Schlemm’s canal through the intrascleral lake. During the first post-operative year the IOP was significantly lowered, no HF related complications were reported and there was less need for goniopuncture in the group of patients treated with Healflow™.
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