HPMC In Balanced Salt Solution
Intraocular Injection
HPMC (Hydroxypropyl methylcellulose) is a clear dispersive viscoelastic device for use as a surgical aid in cataract extraction and intraocular lens (IOL) implantation.
HPMC 2% in Balanced Salt Solution is used to maintain a deep, stable anterior chamber during IOL implantation and protect corneal endothelial cells by coating the cornea throughout the surgical procedure. When used on the surface of the cornea it provides excellent clarity and a level of magnification.
The HPMC comes in a generous 5ml vial which means it can be used liberally to both fill the anterior chamber and coat the cornea. This dual use of HPMC will also allow the surgeon to minimise surgical steps and save time.
Moorfields Pharmaceuticals HPMC is the most frequently used viscoelastic device by surgeons at Moorfields Eye Hospital.
HPMC does not require refrigeration which simplifies storage requirements at hospitals and clinics.
Description
HPMC 2% in Balanced Salt Solution is a sterile, isotonic, apyrogenic viscoelastic solution. It contains 2% Hypromellose with 0.49% Sodium Chloride,
0.39% Sodium Acetate, 0.17% Sodium Citrate, 0.075% Potassium Chloride, 0.048% Calcium Chloride and 0.03% Magnesium Chloride in Water for Injections,
with the addition of Acetic Acid and Citric Acid to control the pH. The nominal viscosity is 4000 mm2s at 20°C.
Indications
HPMC 2% in Balanced Salt Solution is indicated for use as an ophthalmic surgical aid in anterior segment surgical procedures, such as cataract extraction and intraocular lens implantation. HPMC 2% in Balanced Salt Solution maintains a deep chamber during anterior segment surgery allowing for efficient manipulation with significantly less trauma to the corneal endothelium and other ocular tissues. HPMC 2% in Balanced Salt Solution helps the vitreous face to be pushed back preventing formation of a postoperative flat chamber. It is intended for intraocular use only.
Packaging
The product is supplied in 5ml single use glass vials.
Clinical Use
In anterior segment surgery, HPMC 2% in Balanced Salt Solution should be carefully introduced into the anterior chamber using a 20 gauge or smaller cannula. This may be prior to or after removal of the crystalline lens. However, injection prior to delivery of the IOL lens provides additional protection to the corneal endothelium and other ocular tissues, particularly with regard to mechanical damage to these structures from surgical instruments and equipment.
The product may be used to coat the intraocular lens and instrumentation prior to implantation surgery. In the case of foldable lenses, placing HPMC 2% in Balanced Salt Solution into the injector device prior to injecting the lens allows the lens to unfold readily without distortion. During the surgical procedure, additional HPMC 2% in Balanced Salt Solution may be injected at any time to fully maintain chamber depth. At the end of surgery, it is recommended that the product is removed by aspiration, or preferably by use of the irrigating fluid used during surgery (e.g. Hartmann’s or Balanced Salt Solution). HPMC 2% in Balanced Salt Solution removed from the eye, must be treated as clinical waste.
