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Michael Feusier, Sylvain Roy, Alexandre Rizatto, André Mermoud; Healaflow™ For The Modulation Of Postoperative Healing After Deep Sclerectomy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2497.
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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 control after deep sclerectomy surgery.
Classical deep sclerectomy (DS) was performed between January and June 2010. The main diagnoses were primary open angle glaucoma, primary angle closure glaucoma and pseudoexfoliation. Surgeries were performed using Healaflow™ and results were compared against the same surgeries (DS) using collagen implant. The outcomes were the intraocular pressure (IOP), the number of antiglaucoma medication, and the number of complications and bleb management.
For the group with Healaflow™ (n=13) the mean age at surgery was 60.1 ± 10.9 years, the mean follow-up was 9.2 ± 2.1 months, the mean preoperative IOP was 19.8 ± 4.8 mmHg, and the mean number of antiglaucoma medication was 3.0 ± 1.0. At final follow-up visits, the mean IOP was 11.4 ± 3.8 mmHg (p<0.05), the mean number of antiglaucoma medication was 0.2 ± 0.4 (p<0.005), with 6 complications (5 bleb leaks, 1 iris incarceration). Nd:YAG goniopuncture was performed on 7 eyes, and needling of the filtering bleb was done on 5 eyes. No eye required further surgery. In the group with collagen implant (n=17) the mean age at surgery was 63.1 ± 11.0 years, the mean follow-up was 12.5 ± 2.4 months, the mean preoperative IOP was 18.5 ± 3.4 mmHg, and the mean number of antiglaucoma medication was 2.2 ± 1.2. At final follow-up visits, the mean IOP was 11.4 ± 3.4 mmHg (p<0.05), the mean number of antiglaucoma medication was 0.4 ± 0.7 (p<0.005), with 3 complications (1 bleb leak, 2 perforations). Nd:YAG goniopuncture was performed on 11 eyes, needling of the filtering bleb on 10 eyes. Two eyes required further surgical revision of the filtering site. Complete and overall success rates were 85% and 92%, respectively, in the Healaflow™ group, while rates were 71% and 88%, respectively, in the DS group.
The slow resorbable highly crosslinked sodium hyaluronate drainage implant Healaflow™ prevents the postoperative filtering bleb fibrosis and helps in maintaining a functional filtration after glaucoma surgery. The IOP was significantly lowered with a few numbers of postoperative complications and a dramatic reduction in glaucoma medication. Postoperative bleb management was simpler with less goniopuncture and needling of the filtering bleb and no need for further surgeries in the group of patients operated with Healaflow™.
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