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Study finds clear corneal incisions may leak even after suturing
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NEW ORLEANS — In a study of 176 eyes undergoing cataract surgery, 33% of the clear corneal incisions leaked when up to 1 oz. of force was applied, according to a poster presented here at the American Academy of Ophthalmology meeting.
“We were interested in challenging the dogma that sutures are the best way to close a corneal wound,” co-author John A. Hovanesian, MD, FACS, told Ocular Surgery News in an interview.
Hovanesian said that he developed the calibrated force gauge (CFG) with Michael B. Raizman, MD, and Samuel Masket, MD, in order to have the ability to apply quantifiable forces to the eye, simulating increases in IOP.
According to the poster, the patients were evaluated for fluid egress using the CFG before suture application. If the wound leaked when up to 1 oz. of force was applied, it was sutured with 10-0 nylon. After suturing, the wounds were challenged again.
Hovanesian said the take-home message of the study is that one-third of the wounds leaked when 1 oz. or less of force was put on the eye, and 33% of those leaked when 0.25 oz. or less was applied.
“One ounce of force is equal to squeezing the eyes,” Hovanesian said. “We need a better way of sealing wounds.”
Thirty percent of study patients experienced at least one device-related adverse event, according to the poster, and 12.6% of patients had their sutures prematurely removed as a result. Adverse events included subconjunctival hemorrhage, induced corneal astigmatism, infection, corneal edema, eye pain, irritation, discomfort, foreign body sensation and elevated IOP.
Disclosure: The study was sponsored by Ocular Therapeutix. Hovanesian is a consultant for, has received lecture fees and grant support from, and is an equity owner of Ocular Therapeutix.