J Korean Ophthalmol Soc.  2010 Jun;51(6):795-801. 10.3341/jkos.2010.51.6.795.

Clinical Effect of the Mixed Solution of Sodium Hyaluronate and Sodium Carboxymethylcellulose After Endonasal Dacryocystorhinostomy

• Park JW
• Park HY
• Yoon KC

• KMID: 2213598
• DOI: http://doi.org/10.3341/jkos.2010.51.6.795

Abstract

PURPOSE
To evaluate the effects of a mixed solution of sodium hyaluronate and sodium carboxymethylcellulose (HACMC, Guardix-sol(R)) for reducing postoperative adhesion after endonasal dacryocystorhinostomy.
METHODS
Endonasal dacryocystorhinostomy was performed on 58 patients with obstructions of the nasolacrimal system. We divided the 58 patients into two groups. At the completion of endonasal dacryocystorhinostomy, HACMC was applied to the operative site in the experimental group (n=26) and normal saline was applied in the control group (n=32). For the evaluation of clinical effectsand postoperative adhesion, subjective symptom score evaluations, lacrimal irrigation tests, fluorescein disappearance tests, and endoscopic examinations were performed at 1 week, 1 month, 3 months, and 6 months postoperatively.
RESULTS
The HACMC-treated patients showed better results than the control patients for subjective symptom scores, lacrimal irrigation tests, and fluorescein disappearance tests, but these differences were not statistically significant. Upon endoscopic examination, the HACMC group revealed lower incidence of adhesion at 1 week after surgery and lower severity of adhesion throughout the period of observation (p<0.05).
CONCLUSIONS
The application of a mixed solution of HACMC may effectively reduce postoperative adhesion after endonasal dacryocystorhinostomy.

Keyword

Endonasal dacryocystorhinostomy; Guardix; HACMC; Hyaluronate; Sodium carboxymethylcellulose

MeSH Terms

Carboxymethylcellulose Sodium
Dacryocystorhinostomy
Fluorescein
Humans
Hyaluronic Acid
Incidence
Sodium
Carboxymethylcellulose Sodium
Fluorescein
Hyaluronic Acid
Sodium

Figure

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  Figure 1. Incidence and grading of adhesion in the control and HACMC groups on each postoperative day.

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  Figure 2. Comparison of the incidence of adhesion formation in the control and HACMC groups on each postoperative day. In the HACMC group, the incidence of postoperative adhesion was lower than the control groups at 1 week after surgery statistically. * p<0.05 compared with the corresponding each control group.

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  Figure 3. Comparison of the severity of adhesion in the control and HACMC groups on each postoperative day. In the HACMC group, the severity of postoperative adhesion was lower than the control groups throughout the period of observation statistically. * p<0.05 compared with the corresponding each control group.

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