Treatment of chronic ocular hypotony with intraocular application of sodium hyaluronate.

Abstract

The aim of the study was to report the functional and morphological outcome of intraocular injection of sodium hyaluronate for treatment of chronic ocular hypotony (COH). We reviewed the digital chart records of patients with COH who had received one or more injections of intravitreal or intracameral sodium hyaluronate (1.4% or 2.3%). The changes in the best corrected visual acuity (BCVA) and intraocular pressure (IOP) after treatment were recorded. Thirty-two eyes of 32 patients with a mean age of 56.8 years were analysed. Previous vitreoretinal surgery had been performed on all eyes for either ocular-penetrating trauma (six eyes), chronic uveitis (six eyes), full macular translocation (five eyes) or retinal detachment (15 eyes). Mean follow-up time after the first intraocular injection was 29.7 months. BCVA (logMAR) at the baseline and the last follow-up visit were 1.84 (SE 0.65) and 1.82 (SE 0.72), respectively (p = 0.87). The mean IOP at the baseline increased from 2.28 (SE 0.27) mmHg to 7.12 (SE 1.03) mmHg at the last visit (p<0.001). At the final follow-up, 20 eyes (62.5%) had an IOP higher than 5 mmHg and 24 eyes (75%) had an unchanged or improved BCVA. Stabilisation of the IOP and vision in some eyes with COH following vitreoretinal surgery can be achieved with intraocular injection of sodium hyaluronate. Large case-series and long-term follow-up are necessary to confirm the beneficial role of intraocular sodium hyaluronate injections in such eyes.