Intracorneal inclusion of high-molecular-weight sodium hyaluronate following detachment of Descemet's membrane during viscocanalostomy

Cornea. 2000 Jul;19(4):556-7. doi: 10.1097/00003226-200007000-00030.


Purpose: Viscocanalostomy in accordance with Stegmann's technique is a new surgical option in the treatment of glaucoma. There are few reports available describing the specific complications of viscocanalostomy. We report a case of intracorneal inclusion of high-molecular-weight sodium hyaluronate following viscocanalostomy.

Case report: A 66-year-old man with uncontrolled primary open angle glaucoma of his right eye and a history of argon laser trabeculoplasty underwent viscocanalostomy in accordance with Stegmann's technique. During the filling of Schlemm's canal, a limited lysis of Descemet's membrane advanced centrally in the clear cornea adjacent to the site of canalostomy forming an intracorneal bubble of high-molecular-weight sodium hyaluronate. Postsurgical slit-lamp biomicroscopy showed an intracorneal clear bubble within the corneal periphery without evidence of adjacent corneal edema and with no contact between the corneal endothelium and the iris. Follow-up examinations determined that the appearance of the corneal inclusion, essentially, was unchanged, with only a slight tendency of resorption. No signs of corneal scarring or endothelial decompensation could be noted.

Conclusion: To date, we could not determine a significant corneal damage in conjunction with the described complication. However, it is difficult to predict the long-term clinical course of our patient. Corneal decompensation as a result of possible endothelial toxicity of high-molecular weight sodium hyaluronate as well as spontaneous absorption seem possible.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Corneal Edema / chemically induced*
  • Corneal Edema / pathology
  • Descemet Membrane / diagnostic imaging
  • Descemet Membrane / pathology*
  • Descemet Membrane / surgery
  • Filtering Surgery / adverse effects*
  • Glaucoma, Open-Angle / pathology
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Hyaluronic Acid / adverse effects*
  • Injections
  • Intraocular Pressure
  • Male
  • Surgical Flaps
  • Ultrasonography
  • Visual Acuity


  • Hyaluronic Acid