Effect of sodium hyaluronate on immediate postoperative intraocular pressure after extracapsular cataract extraction and IOL implantation.

We studied 129 eyes which were undergoing extracapsular cataract extraction with IOL-implantation. The amount of residual Healon had a clearcut effect on the IOP elevations postoperatively. In eyes operated on with the intercapsular techniques, pressure elevations and the mean values during the first 6 postoperative hours were significantly higher than in eyes operated on with the planned ECCE (can opener-technique) (P less than 0.01). The pressure elevation reached the maximal values 8-12 h postoperatively and had normalized already at 24 h in most cases, except in glaucomatous eyes which at that time had significantly higher mean IOP values than the non-glaucomatous eyes (P less than 0.01). When operations were done with an air bubble no clearcut postoperative pressure increases could be observed. Our study indicates that a comparatively small amount of Healon may cause a pressure elevation and the amount left in the eye has a greater effect upon the level of the pressure than the duration of the pressure elevation. The less we inject Healon into the eye and the more we avoid leaving it there, the less risk we have of the possibility of vision deteriorating high postoperative intraocular pressure.