Descemet's membrane detachment by sodium hyaluronate
D. L. Hoover, J. Giangiacomo and R. L. Benson
The inadvertent injection of sodium hyaluronate (Healon) just anterior to
Descemet's membrane during an extracapsular cataract extraction resulted in
a corneal opacity. No extraordinary measures were taken to remove this
substance. The opacity resolved over five months, with a final visual
acuity of 20/25 and a reduction in specular microscopic cell density from
2,600 to 2,100/sq mm. Sodium hyaluronate was injected in an analogous
manner into eight rabbit corneas. The eyes were enucleated, and histologic
sections were examined 1, 5, 9, and 14 days later. Sodium hyaluronate
injected just anterior to Descemet's membrane was found to incite an acute
mild granulocytic response, which is followed by a macrophage invasion and
ingestion of this substance. We recommend a conservative approach when the
central portion of Descemet's membrane is detached by sodium hyaluronate
during anterior segment surgery.
