✍ Scribed by C. D. Binkhorst
No coin nor oath required. For personal study only.
The author studied the use of Na-hyaluronate in intraocular lens implantation. Advantages and disadvantages are discussed.
Healon is a purified one-percent solution of Na-hyaluronate, prepared from rooster combs and marketed by Pharmacia Fine Chemicals, Uppsala, Sweden. Na-hyaluronate is itself a physiological substance that is found, among other places, in the vitreous and in the anterior segment of the eye. Healon is a crystal-clear visco-elastic substance that is under investigation as an aid in intraocular surgery, among other uses for the protection of the corneal endothelium from mechanical damage from instruments and from the lens itself during intraocular implantation (Balasz, Miller & Stegmann, 1979; Miller & Stegmann, in press). There are also reports on its use as a vitreous substitute (Pruett, Schepens & Swarm, 1979). A small amount of Healon was given to the author for clinical trial.
After extracapsular cataract extraction about 0.25 ml. Healon was injected into the anterior chamber of 13 selected patients prior to the insertion of a two-loop capsular bag-supported Morcher intraocular lens, while the fellow eyes servea as control. In another 7 selected patients, with the exception of the use of Healon, the same 'deep chamber technique' of cataract extraction and lens implantation was performed (Binkhorst, Nygaard & Loones, 1978). These patients also served as control. Visibility in the anterior chamber filled with Healon was found to be excellent, as good as, or better than, in the anterior chamber filled with fluid and much better than in the anterior chamber filled with air. During the injection of Healon an atonic iris occasionally showed a tendency to prolapse. The manipulations of lens insertion were facilitated and the corneal endothelium was certainly well protected from mechanical damage. Pupil constriction at the end of surgery was slightly inhibited. The correction of gonio-adhesions of the iris root and of coloboma pillars could not be carried out under direct visual control whereas, with the anterior chamber filled with air, this can be done under direct gonioscopy. This seemed to be the only serious drawback Documenta Ophthalmologica 50, 233-235 (1981).
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