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R.A. Adelman, Y. Liu, J. Zhang; The Protective Effect of Sodium Hyaluronate on the Corneal Endothelium During Vitreoretinal Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2992.
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Purpose: During vitreoretinal surgery on aphakic eyes with absent posterior capsule, the turbulent flow of irrigation may cause corneal edema and Descemet's membrane folds. We studied whether sodium hyaluronate (Healon) has a protective effect on the corneal endothelium during vitreoretinal surgery. Methods: In a prospective clinical trial, 83 aphakic eyes with absent posterior capsule underwent vitreoretinal surgery. These eyes were divided in two groups, Group 1: the anterior chamber was filled with sodium hyaluronate before starting vitrectomy (n=66), Group 2: vitrectomy without sodium hyaluronate in the anterior chamber (n=17). At the end of surgery sodium hyaluronate was flushed with balanced salt solution from the anterior chamber into the vitreous cavity and then was aspirated. Central corneal thickness was determined by ultrasound pachymetry before surgery and again 2 days after surgery. Results: The incidence of severe corneal edema was 7.7% in the sodium hyaluronate group and 38.5% in the control group for the surgeries lasting less than 2 hours (P=0.012). In surgeries longer than 2 hours severe corneal edema was 21.4% in the sodium hyaluronate group and 100% in the control group (p=0.011). Conclusions: Filling the anterior chamber with sodium hyaluronate is effective in protecting the corneal endothelium in vitreoretinal surgeries in aphakic eyes. Sodium hyaluronate significantly reduces the degree of corneal edema. This may result in better visualization during vitreoretinal surgeries.
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