The Effect of Viscoelastic Substance for Trabeculectomy.

Moon, Jung Il; Chang, Yong Ik; Park, Chan Kee

Original Article

Journal of the Korean Ophthalmological Society 2001;42(1):79-84.
Published online January 1, 2001.

The Effect of Viscoelastic Substance for Trabeculectomy.

Jung Il Moon, Yong Ik Chang, Chan Kee Park

Department of Ophthalmology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea.

녹내장 섬유주절제술에 사용한 점탄물질의 효과

문정일(Jung Il Moon),박찬기(Chan Kee Park),장용익(Yong Ik Chang)

Abstract

The viscoelastic substance has been used popularly in trabeculectomy. Hence, the authors compared the safety and postoperative influence in viscoelastic substance use group with non-use group in trabeculectomy. The authors evaluated 20 eyes of 10 open-angle glaucomatous patients undergoing trabeculectomy who had had no systemic disease, no ocular trauma history, and over 21 mmHg intraocular pressure though over 2 eye drops and over one time p.o. medications a day. One eye of these patients used viscoelastic substance(Viscoat(r), Alcon, U.S.A.)and the other did not. The authors measured intraocular pressure and anterior chamber depth at postoperative 1 day, 3 days, and 7 days and measured corneal endothelial cell numbers at preoperative and postoperative 1 month and examined complications such as anterior chamber hemorrhage, anterior chamber inflammation and cataract progression. Viscoelastic substance did not influence intraocular pressure, anterior chamber formation and corneal endothelial cell damage postoperatively in trabeculectomy(p>0.5). But as complications, intraoperative iris prolapse in two eyes, postoperative anterior chamber hemorrhage in a eye, and postoperative cataract progression in a eye developed and anterior chamber inflammation was also worse in the non-viscoelastic substance use group. Conclusively, the viscoelastic substance would reduce intraocular tissue damage, make intraoperative bleeding control easy and prevent anterior chamber collapse immediately after operation in trabeculectomy. Because only open angle glaucoma was studied in the present research, further study was applied to acute angle closure glaucoma, neovascular glaucoma which is apt to bleed, and glaucoma with cataract or uveitis in which intraoperative intraocular damage is minimized.

Key Words: Trabeculectomy;Viscoelastic substance