Sodium hyaluronate, the salt form of hyaluronic acid, is a naturally occurring polysaccharide group of sugar in the human body. It is a popular ingredient in skincare and cosmetics due to its ability to hydrate and plump the skin. This sodium salt also has a wide range of applications in the medical field, particularly in anterior segment eye surgery. In this article, we will discuss the utilization and benefits of sodium hyaluronate in anterior segment surgery.

What Is Anterior Segment Surgery?

Anterior segment surgery involves operating on the structures in the front of the eye, such as the cornea, iris, and lens. These surgeries can range from cataract removal to corneal transplants. It is crucial to maintain the clarity of the cornea and the surrounding tissues to ensure a successful outcome. Sodium hyaluronate can play an essential role in achieving this.

Human Eyes

Benefits of Sodium Hyaluronate Employed in Anterior Segment Surgery

Sodium hyaluronate is a natural substance largely found in the extracellular matrix of connective tissues. It is in the aqueous humor and the vitreous, and it forms a protective coating on the corneal endothelium. Sodium hyaluronate and other viscoelastic substances, such as chondroitin sulfate and collagen, have been used for eye surgeries since the 1970s. These viscoelastic agents are used to protect and maintain the shape of the eye during surgery. They help create space for the surgeon to work and prevent damage to delicate structures as well.

Eye Anatomy

–Maintaining A Deep Anterior Chamber

The primary benefit of using this salt as a viscoelastic agent is its ability to maintain a stable anterior chamber during the operation. The anterior chamber is the fluid-filled space between the cornea and the iris, and maintaining its stability is essential for successful surgery. Sodium hyaluronate can help stabilize the anterior chamber by providing a cushioning effect and preventing the collapse of the chamber. Therefore, it is easier to separate and maneuver these tissues, and the damage to the cornea and other tissues can be minimized.

–Protecting the Corneal Endothelium

Besides, the excellent lubricating properties of sodium hyaluronate can help reduce the risk of damage to the corneal endothelium during surgery. The corneal endothelium is a layer of cells that lines the back of the cornea, which is crucial for maintaining corneal clarity. Damage to the corneal endothelium can result in complications such as corneal edema and decreased vision. If it got scratched, there would be serious vision problems because all light passes through it and any defect might lead to a “blind spot”.

–No Adverse Effect

Sodium hyaluronate is a substance widely present in the human body, and there is no report on its adverse effects. So, it is considered to have no adverse effects and is safe to take. It is also biocompatible, meaning it is well-tolerated by the body and does not cause adverse reactions. Moreover, sodium hyaluronate can be easily absorbed by the body and does not require removal after surgery.

Sodium hyaluronate is available in various forms, including gels, solutions, and ointments. The choice of form depends on the specific needs of the surgery and the surgeon’s preference. There is a variety of medical-grade sodium hyaluronates on our website. Send us an inquiry if you are interested.

Related reading: Medical-grade Sodium Hyaluronate Guide 2023: Functions & Applications

Examples of Sodium Hyaluronate Used in Anterior Segment Surgery

You can find sodium hyaluronate as a surgical aid during ophthalmic surgeries including cataract extraction, corneal transplant, glaucoma infiltration, and intraocular lens implantation. With sodium hyaluronate products, the safety and reliability of anterior segment eye surgeries have been improved.

–Cataract Operations

Sodium hyaluronate was used as a surgical device for two cataract surgeries: intracapsular cataract extraction (ICCE) with corneoscleral incision and corneal incision. There were 80 patients divided in two groups. The first group used sodium hyaluronate products, while the control group employed a balanced salt solution (BSS) instead. It was proven that this sodium salt has a protective effect on the cornea and no side effects, such as intraocular pressure or inflammatory reaction, have been observed. [2]

–Intraocular Foreign Body (IOFB)

Diverse surgical instruments have been employed to remove intraocular foreign bodies (IOFBs). A 38-year-old healthy man suffered from a glass IOFB in the left eye after a glass exploration. Medical-grade sodium hyaluronate gel was used to remove the IOFB, which could avoid damage to the retina and make it easier to grasp the flat glass fragment. [3]

Conclusion

In a word, sodium hyaluronate is a useful tool in anterior segment surgery. Its viscoelastic properties can help maintain a stable anterior chamber and protect delicate structures during surgery. Its lubricating properties can reduce the risk of damage to the corneal endothelium, and its biocompatibility makes it a safe choice for use in surgery. If you are undergoing anterior segment eye surgery, be sure to discuss the use of sodium hyaluronate with your surgeon and learn about how it can benefit your surgery.

Stanford Chemical Company is a leading supplier of medical-grade sodium hyaluronate. Cosmetic grade, food grade, and injection grade are also available. Check our homepage to look for the perfect sodium hyaluronate products for your projects.

Reference:

[1] Souto, Eliana B. & Zielińska, Aleksandra & Luis, M. & Carbone, Claudia & Martins-Gomes, Carlos & Souto, Selma & Silva, Amélia. (2019). Uveal melanoma: physiopathology and new in situ-specific therapies. Cancer Chemotherapy and Pharmacology. 84. 10.1007/s00280-019-03860-z.

[2] Åke S. Holmberg, Bo T. Philpson, (1984). Sodium Hyaluronate in Cataract Surgery: I. Report on the Use of Healon® in Two Different Types of Intracapsular Cataract Surgery. Ophthalmology, 91(1), 45-52. https://doi.org/10.1016/S0161-6420(84)34341-X.

[3] Zhang J, Mao H, Zou X, Deng G. (2020). Use of medical sodium hyaluronate gel in surgical removal of a glass intraocular foreign body. Journal of International Medical Research, 45-52. https://doi.org/10.1177/0300060520956856.

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The first known cornea transplantation is claimed to be performed in 1905 by Eduard Zirm (at the Olomouc Eye Clinic, now the Czech Republic), making it one of the first types of transplant surgery successfully performed. There is information in the literature, however, that back in the 1970s, the implantation of the lens inside the eye was often followed by severe edema, due to cell damage during the surgery. The need for a viscous, clear, physiologic lubricant to prevent such cells from scraping was getting evident. The first HA products are reportedly developed in the 1970s and 1980s and later approved for use in eye surgery in a variety of ways.

Nowadays, special hyaluronan solutions, known as ophthalmic viscoelastic devices (OVDs), are widely used in surgery on the surface and inside the eye to prevent dryness and to stimulate faster-wound healing. Medical grade hyaluronic acid and a number of its derivatives facilitate procedures, including vitreoretinal surgery, cataract surgery, anterior segment surgery, glaucoma surgery, and corneal transplantation.

In some cases, these products could be directly injected into the eye during surgical procedures to maintain the shape of the eye.

Other hyaluronic acid-based biomedical products (various kinds of eye cells and tissue implants or substitutes) have also been showing excellent biocompatibility, and tolerance, and encouraging efficacy in ophthalmic surgery. Some of them have been extensively studied and approved others are still being investigated in the long process of official clinical confirmation and results in verification.

Apart from its surgical application, hyaluronic acid in an aqueous solution, under the form of artificial tears, has proved to be an effective means of reducing dry eye symptoms and improving the vitality of the eye cells.

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The polyanionic form, commonly referred to as hyaluronan, is a visco-elastic polymer found in the aqueous and vitreous humor of the eye and in the fluid of articulating joints.

Hyaluronic acid(HA) is a straight-chain macromolecular mucopolysaccharide composed of repeat disaccharide units of glucuronic acid and N-acetylglucosamine. It widely consists of the extracellular space of human and animal tissue, vitreum, umbilical cord, skin joints synovia, and cockscomb, etc.

Most cosmetic manufacturers make use of high molecular weight HA. This ingredient, when used at optimal levels of inclusion, is an incredibly effective moisture-binding element, providing superficial hydration of the epidermis for many hours. However, this ingredient is a macro-molecule and is too large to penetrate into the deeper layers of the skin.

Low molecular weight HA, on the other hand, has been engineered to exist as a far smaller molecule that is able to penetrate through the epidermis to provide deep hydration. It has been scientifically proven that increased levels of hyaluronic acid in the deeper layers of the skin actually stimulate the production of collagen fibers, which in turn will result in a firmer, more toned appearance.

HA is a new biological at home and abroad. Its molecular weight is from several ten thousand to several million. Its aqueous solution has outstanding moisture-keeping ability, high viscoelasticity, and lubricity. It is widely used in cosmetics, pharmacy and health, and beautiful food.

Biochemical drugs with high clinical value, are widely used in all kinds of eye surgery, such as crystal implantation, corneal transplantation, glaucoma surgery, etc.

It can also be used to treat arthritis and accelerate wound healing.

It is used in cosmetics, it can have a unique skin protection effect, can keep skin moist and smooth, delicate, soft, and elastic, has anti-wrinkle,  beauty care, and restore the skin physiology function.

1. Food supplements:

Hyaluronic Acid Powder through oral administration after digestion absorption, increases in vivo Hyaluronic Acid synthesis of the precursor, causing the skin and other organizations’ Hyaluronic Acid resultant quantity increases, thus enabling the skin the water retention property to increase, gaining rich elasticity, and reducing wrinkles.

2. Cosmetics applications:

Hyaluronic Acid Powder has an outstanding moisture-keeping ability, thus called the Natural Moisturizing Factor in the world. Hyaluronic Acid is a common ingredient in skin-care products, which can be used as a very effective topical humectant, which can be used for facial wrinkles, reduction of folds and wrinkles, and removal of scars.

3. Medical applications:

Hyaluronic Acid Powder could be used in eye surgery, such as corneal transplantation, cataract surgery, glaucoma surgery, and surgery to repair the retinal detachment.

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