Hyaluronic acid

Uses

Hyaluronic acid is considered to have low inflammatory and antigenic potential, and has been used in various intraocular procedures. In addition to filtration bleb formation, it has been used to protect the corneal endothelium during intraocular lens implantation and keratoplasty, to reform the anterior chamber, to push back a bulging vitreous face, and in retinal detachment surgery as a vitreous replacement.

Hyaluronate sodium is also combined with sodium chondroitin sulfate (in Viscoat) as a corneal transplant preservation medium. Sodium chondroitin sulfate and other viscoelastic substances protect the corneal endothelium during intraocular surgery.

Hyaluronic acid is used topically to promote wound healing. A film containing hyaluronate sodium and carmellose is used to prevent surgical adhesion. Hyaluronic acid is increasingly being used in cosmetic dermatology to treat wrinkles in patients who are sensitive to bovine collagen.

Intra-articular injections of hyaluronic acid formulations of different molecular weights have been used in patients with osteoarthritis and can provide short-term benefit [ ].

Non-animal-stabilized hyaluronic acid/dextranomer gel has been used as a cosmetic filler and to treat vesicoureteric reflux in children by endoscopic injection [ ]. In 166 patients, mean age 4.2 (range 0–16) years reflux was resolved in 82% after one treatment and in 90% after a second or third treatment; there were no adverse reactions. In a similar study in 71 patients the response rate at 12 months after the last endoscopic treatment was 62%; there were two mild adverse events and one moderate laboratory change potentially relating to the gel [ ]. The effects of hyaluronic acid can be reversed by hyaluronidase [ ].