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Hydrogel sealant offers alternative to sutures
WASHINGTON — Hydrogel sealant is a viable alternative to sutures to prevent wound leakage during cataract surgery, according to a speaker here.
With more than 3 million cataract surgeries performed each year, most of which utilize a clear cornea incision, which is slower to heal than a scleral incision, better wound closure options are necessary, Leon W. Herndon Jr., MD, said at Glaucoma Day at the American Society of Cataract and Refractive Surgery meeting.
“ReSure sealant (Ocular Therapeutix) provides adequate wound integrity for use in a wide variety of combination phaco/glaucoma procedures,” Herndon said.
The hydrogel sealant is indicated for intraoperative management of clear corneal incisions, according to the company website.
“Suturing the wound used to be considered the gold standard; however, now it’s becoming antiquated technology with several disadvantages,” Herndon said.
In addition to corneal trauma, risk of inflammation, neovascularization and astigmatism, studies have shown 34% of these sutures can leak with minimal pressure, he added.
These leaks allow fluid to enter or leave the incision and can cause hypotony, corneal decomposition, epithelial downgrowth and endophthalmitis, as well as compromise refractive outcomes, according to Herndon. Hydrogel sealant minimizes risks by preventing egress of fluid from clear corneal incisions.
The recent pivotal clinical trial, in which a wound challenge test was conducted in 487 patients at 24 U.S. sites, found wound leakage rates of 4.1% in those in whom the hydrogel sealant was used, in contrast to 34.1% of patients with sutures, Herndon said. – by Rebecca L. Forand
Reference: Herndon L. Suturing or gluing the corneal wound. Presented at: American Society of Cataract and Refractive Surgery annual meeting; April 13-17, 2018; Washington.
Disclosure: Herndon reports no relevant financial disclosures.