EyeWorld India March 2020 Issue

24 EWAP MARCH 2020 SECONDARY FEATURE Using surgical glue Another wound sealing option is the ReSure Sealant (Ocular Therapeutix), which is FDA- approved for cataract wounds. The hydrogel material is designed to be painted on an external wound at the end of surgery, dissolving and hydrolyzing over several days to provide time for the wound to self-seal. “The material is easy to use, it can be stored in the operating room for months, and is clinically proven to work better than sutures at sealing incisions,” said Dr. Hovanesian, who served on the clinical trials for the sealant. He said the trials compared wounds that were sutured with those that were closed with ReSure. They found that the wounds closed with the sealant were more resistant to external compression. “Because of the cost of ReSure, it may not be for every cataract surgery but it certainly is a product that should be available in every operating room, because a variety of complications can occur during surgery that make a wound very hard to seal,” Dr. Hovanesian said. Cases that could benefit from the sealant include wound burns, interfering, pre-existing incisions (like those from RK), trauma cases, and irregular corneal incisions. There are certain types of patients who can benefit from use of a sealant as well, Dr. Hovanesian said. They include patients with poorly healing wounds, such as those with diabetes; those unlikely to take their drops; those prone to touching their eye; those prone to complications if wound leak were to occur (such as patient with IFIS or pseudoexfoliation); and patients receiving an accommodating IOL where wound seal can help ensure a good refractive outcome. ReSure is packaged as two dry components and a liquid activator in a dropper bottle. The surgeon places two drops of the liquid into the activator and mixes it with the white hydrogel material for about 5 seconds. The mixture is then applied to the surface of the wound where it will polymerize. Dr. Hovanesian noted that wounds need to be dry before the sealant is applied. “If it is actively leaking at the time, it is like trying to put paint on a surface that has a leak coming through it,” Dr. Hovanesian said. “It doesn’t work well.” Lowering the pressure in the eye can reduce leaks and provide the 30 seconds it takes for the sealant to polymerize. EWAP Editors’ note: Dr. Hovanesian is clinical assistant professor at the UCLA Jules Stein Institute, Los Angeles, and has relevant financial interests with Ocular Therapeutix. Dr. Donaldson is professor of clinical ophthalmology, Cornea/ External Disease/Cataract and Refractive Surgery, medical director of Bascom Palmer Eye Institute, and has relevant financial interests in Alcon, Bausch & Lomb, Johnson & Johnson. Discover a New World OCULUS Corvis ® ST Novel diagnostic solutions based on corneal biomechanics Biomechanical assessment before refractive surgery has been essential since the introduction of the Tomographic Biomechanical Index. The Corvis ® ST software now includes novel features that open up the field for further applications such as laser vision correction and corneal crosslinking. A new revolutionary glaucoma screening software completes the update. Biomechanical Comparison Display Unique: Stress-strain curves Biomechanical assessment after LVC Glaucoma screening software New Features! OCULUS Asia Ltd. corneal-biomechanics.com • info@oculus.hk KLB Instruments Co. Pvt. Ltd KLB ASCRS Eyeworld Corvis ST Discover a New World - nur Produkt 123.4x247.7 ind 02.20 v2.indd 1 27.02.2020 16:56:22