Treatment of chronic ocular hypotony with intraocular application of sodium hyaluronate

Aim: 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). Methods: 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. Results: 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. Conclusions: 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.