Sodium hyaluronate in trabeculectomy: effect on early complications

PURPOSE: To evaluate the effect of sodium hyaluronate on the early complications of trabeculectomy. METHODS: In this prospective study, trabeculectomy was performed in 51 eyes of 51 patients with different types of glaucoma. Patients were divided into two groups randomly. In 24 eyes (study group) sodium hyaluronate was injected into the anterior chamber after suturing the scleral flap. In the remaining 27 eyes (control group) only balanced salt solution was injected. Visual acuities, intraocular pressures and early complications were evaluated. RESULTS: Preoperative mean intraocular pressures were similar in the two groups (34.5 +/- 18.7 mmHg in the study group and 37.2 +/- 18.1 mmHg in the control group). In the first postoperative day mean intraocular pressure difference was significant (16.8 +/- 7.1 mmHg in the study group and 9.0 +/- 6.6 mmHg in the control group, P < 0.01). There was significant difference in occurrence of hypotony (8.3% study vs. 40.7% control), anterior chamber shallowing (8.3% study vs. 37% control) and choroidal detachment (none in study vs. 33.3% control) between the two groups (P < 0.01). Early intraocular pressure peak, occurred more common in the study group (20.8%) than in the control group (11.1%), but the difference was not significant (P > 0.01). Hyphema occurred in two (8.3%) eyes in the study group, and three (11.1%) in the control group. This was not significant (P > 0.01). The clearance time of blood from the anterior chamber (less than 1 week) was also similar in the two groups. CONCLUSION: Sodium hyaluronate-assisted trabeculectomy decreased the incidence of early postoperative complications like anterior chamber shallowing, choroidal detachment and hypotony, but it did not have any effect on hyphema or its clearance.