EyeWorld Asia-Pacific December 2014 Issue
31 EWAP CATARACT/IOL December 2014 surgery you had to use a fluorescein strip and do a Seidel test in the OR, and if the wound leaked spontaneously then the patient qualified,” Dr. Kim said. “If it didn’t leak spontaneously, a force gauge was placed on the posterior lip of the wound.” Up to 1 ounce of force was used to see if the wound would leak. In cases where leakage was seen, patients were randomized to either the suture or the ReSure group. Then patients had to undergo a second wound leakage challenge with these same steps, Dr. Kim explained. “If they showed leakage with that, they were considered a primary endpoint failure,” he said. “If they didn’t leak, either spontaneously or with up to 1 ounce of force, they were considered successfully sealed with either suture or sealant.” Sealant versus sutures When investigators compared leakage rates here, they were surprised to find that this was 8 times higher for the suture group. “I didn’t expect that,” Dr. Kim said. Also, overall adverse events were significantly lower with the ReSure Sealant compared to the suture group, he said. Meanwhile, practitioners in the study considered the sealant easier to use, with 94% scoring it as “easy” or “very easy” to apply. The ReSure Sealant can be applied in less than 30 seconds. Source (all): Terry Kim, MD Patients in more complex surgical cases such as those involving the Malyugin ring may be good candidates for the use of the ReSure Sealant. by Maxine Lipner EyeWorld Senior Contributing Writer Seal of superiority Sealant lowers cataract wound leakage rates J ust because a cataract wound appears closed does not mean it is necessarily leak proof, according to Terry Kim, MD , professor of ophthalmology, Duke University Eye Center, Durham, NC, U.S. Rates of wound leaks with stromal hydration alone can reach 85%, he said. New results indicate that the recently approved ReSure Sealant (Ocular Therapeutix, Bedford, Mass., U.S.) is far more likely to prevent leaks than sutures. In the study, presented at the 2014 ASCRS•ASOA Symposium & Congress, the leak rate for the suture group was determined to be 34.1% compared to just 4.1% for the ReSure Sealant, Dr. Kim said. In the prospective trial, investigators enrolled 488 eyes slated for cataract surgery at 24 sites. The aim was to compare any leakage with the ReSure Sealant to traditional sutures. In the study, a peer-reviewed ocular force gauge designed by Samuel Masket, MD , and John Hovanesian, MD , was used to help test for leaks. Only patients who showed signs of leakage were included in the study, Dr. Kim said. “At the end of the cataract continued on page 32
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