A novel use of reticulated hyaluronic acid (Healaflow) for hypotony eyes in patients with uveitis

Abstract

Persistent ocular hypotony is a complex and ongoing challenge faced in ophthalmology. It can result in early ocular phthisis and associated visual decline, pain and deformity. We present the first case series, in which repeated intracameral injections of highly reticulated hyaluronic acid (Healaflow) have successfully prevented the complications of ocular hypotony in the long term. We believe it is a viable management option that can bring about a significant improvement to the quality of life in this subgroup of patients while avoiding frequent intervention.

Patching Retinal Breaks With Healaflow in 27-Gauge Vitrectomy for the Treatment of Rhegmatogenous Retinal Detachment

“…Third, Healaflow has been used in the treatment of patients with persistent ocular hypotony and atrophy of the eyeball. 14 Our in vitro experiment also confirmed that Healaflow could continue to be attached and insoluble for at least two weeks in a 37°C water bath. Although this cannot fully simulate the changes in Healaflow in the human eye in its constant movement state, animal experiments have verified the safety and effectiveness of vitreous cavity filling in rats.…”

“…It is a commercially available translucent hydrogel and has been used in glaucoma filtering surgery as a space filler and to prevent postoperative scarring. 14 Healaflow is a slow resorbable and self-degrading viscoelastic agent. The ordinary viscoelastic agent can stay for 24 hours to 48 hours, but Healaflow can stay for more than 6 months to 9 months.…”

Improvement Production of Hyaluronic Acid by Streptococcus zooepidemicus in Sugarcane Molasses

“…Hyaluronic acid (HA) is a linear polysaccharide composed of disaccharide units of (1,4)-βlinked glucuronic acid and (1,3)-β-linked N-acetylglucosamine [1]. Due to its unique physicochemical properties, such as high intrinsic viscosity, antioxidant properties, chain stiffness and water-holding capacity [2], HA has been used for a wide variety of medical applications, including osteoarthritis [3,4], ophthalmic surgery [5,6] and cutaneous wound healing [7,8]. In dermatology and cosmetic practices, HA has been employed to help the skin regain elasticity, turgor and moisture [9,10].…”

Ab interno tube ligation for refractory hypotony following non-valved glaucoma drainage device implantation

“…Common practice is to use intracameral injections of OVD or total ligation of the external portion of the drainage tube using non-absorbable sutures [8]. The former option may require multiple injections of OVD due to their short-lived effect, although more viscous devices such as reticulated hyaluronic acid have recently been used to prevent phthisis and maintain aesthetic appearance in pre-phthisical blind eyes with chronic hypotony [11]. One third of our cases had previous cyclo-destructive procedures, which may explain the poor resolution of hypotony in these eyes using fixed-volumes of repeated intracameral OVD injections.…”