Sodium hyaluronate

The sodium salt of hyaluronic acid, a glycosaminoglycan found in various connective tissue of humans.

It is a glycosaminoglycan and long-chain polymer of disaccharide units of Na-glucuronate-N-acetylglucosamine.

Trade names Healon, Provisc, Viscoat, Hyalgan, Euflexxa, Supartz, Gel-One

Its polyanionic form is a visco-elastic polymer found in the aqueous and vitreous humour of the eye and in the fluid of articulating joints.

It is distributed widely in the extracellular matrix of mammalian connective, epithelial, and neural tissues, as well as the corneal endothelium.

It is functions as a tissue lubricant.

It is thought to play an important role in modulating the interactions between adjacent tissues.

It provides protection for iris, retina, and cell layers of the cornea, endothelium, and epithelium by its high viscosity of the solution.

It assists in absorbing mechanical stress and provides a protective buffer for tissues.

It acts as a protective transport vehicle, taking peptide growth factors and other structural proteins promoting tissue healing, at the site of action.

In the eye sodium hyaluronate is cleared within hours of injection but has residual effects on contacted cells.

In the eye sodium hyaluronate is eliminated via the canal of Schlemm.

When used to treat the joints, adverse reactions are rare.

It may cause postoperative inflammation, corneal edema or decompensation, and short-term increases in intraocular pressure, when used in ophthalmological procedures.

It is used to treat knee pain in patients with osteoarthritis.

When injected into the joint capsule, to act as both a shock absorber and a lubricant for the joint, and reduces pain in the joint.

It is generally used before surgery, providing symptomatic relief, by recovering the viscoelasticity of the articular fluid, and by stimulating new production from synovial fluid, and may reduce the need for joint replacement.

Injections appear to increase in effectiveness over the course of four weeks, reaching a peak at eight weeks.

It retains some effectiveness at six months.

It has greater benefit for osteoarthritis than oral analgesics.

It acts as an aid in ophthalmic surgery acting as aqueous and vitreous humor in cataract extraction, intraocular lens implantation, corneal transplant, glaucoma filtration, and retina attachment surgery and in the treatment of dry eyes.

Instillation of sodium hyaluronate into the anterior segment of the eye allows its viscoelasticity enabling the maintenance of a deep chamber, since the solution does not flow out of the open anterior chamber, allowing for efficient manipulation with less trauma to the corneal endothelium and other surrounding tissues.

It serves as a surgical aid to gently separate, maneuver, and hold tissues.

It allows a clear field of vision, facilitating intra-operative and post-operative inspection of the retina and photocoagulation.

Also used to coat the bladder lining in treating interstitial cystitis.

Is used to reduce wrinkles on the face, as dermal fillers.

Topically applied it can facilitate the absorption of pharmaceuticals, and function like a nanocarrier.

In normal skin, low-molecular weight hyaluronate enhances penetration into the epidermis.

It is ontraindicated in people who are sensitive to hyaluronate preparations, or when there are infections or skin disease at the injection site.