Seenu M Hariprasad1, Ajay Singh. 1. Department of Surgery, Section of Ophthalmology and Visual Science, University of Chicago, Chicago, IL 60637, USA. retina@uchicago.edu
Abstract
OBJECTIVE: To test a novel hydrogel sealant to secure sutureless sclerotomies under variable intraocular pressure conditions. METHODS: In cadaver eyes, 23- and 20-gauge (G) sclerotomies were constructed. Sixteen 23-G beveled sclerotomies were constructed in 4 eyes: 8 of the incisions were treated with hydrogel sealant, while 8 were left bare. All sclerotomies were monitored for leaks while the intraocular pressure was elevated. The pressure on incision leakage was recorded as the leak pressure (maximum tested = 140 mm Hg). Additionally, sixteen 20-G sclerotomies were constructed in 4 other eyes: 8 of the incisions were treated with hydrogel sealant, while 8 were sutured. These incisions were similarly pressure tested. RESULTS: Among the 23-G incisions, hydrogel sealant application to the incisions significantly increased the leak pressure relative to bare incisions: mean (SE), 131.8 (8.2) vs 39.5 (5.2) mm Hg, respectively (P < .001). Only 1 of the 8 sealant-treated 23-G incisions leaked below 140 mm Hg, compared with all of the 8 bare incisions. Among the 20-G incisions, there was no difference in leak pressure among sealant-treated and sutured incisions: mean (SE), 140.0 (0.0) vs 136.3 (3.8) mm Hg, respectively (P = .35). None of the 8 sealant-treated 20-G incisions leaked below 140 mm Hg, compared with 1 of the 8 sutured incisions. CONCLUSIONS: Hydrogel sealant significantly increased the leak pressure among 23-G incisions relative to 23-G bare incisions and was equivalent to suturing among 20-G incisions. CLINICAL RELEVANCE: Hydrogel sealants effectively close vitrectomy incisions and may decrease the incidence of postoperative endophthalmitis and hypotony.
OBJECTIVE: To test a novel hydrogel sealant to secure sutureless sclerotomies under variable intraocular pressure conditions. METHODS: In cadaver eyes, 23- and 20-gauge (G) sclerotomies were constructed. Sixteen 23-G beveled sclerotomies were constructed in 4 eyes: 8 of the incisions were treated with hydrogel sealant, while 8 were left bare. All sclerotomies were monitored for leaks while the intraocular pressure was elevated. The pressure on incision leakage was recorded as the leak pressure (maximum tested = 140 mm Hg). Additionally, sixteen 20-G sclerotomies were constructed in 4 other eyes: 8 of the incisions were treated with hydrogel sealant, while 8 were sutured. These incisions were similarly pressure tested. RESULTS: Among the 23-G incisions, hydrogel sealant application to the incisions significantly increased the leak pressure relative to bare incisions: mean (SE), 131.8 (8.2) vs 39.5 (5.2) mm Hg, respectively (P < .001). Only 1 of the 8 sealant-treated 23-G incisions leaked below 140 mm Hg, compared with all of the 8 bare incisions. Among the 20-G incisions, there was no difference in leak pressure among sealant-treated and sutured incisions: mean (SE), 140.0 (0.0) vs 136.3 (3.8) mm Hg, respectively (P = .35). None of the 8 sealant-treated 20-G incisions leaked below 140 mm Hg, compared with 1 of the 8 sutured incisions. CONCLUSIONS: Hydrogel sealant significantly increased the leak pressure among 23-G incisions relative to 23-G bare incisions and was equivalent to suturing among 20-G incisions. CLINICAL RELEVANCE: Hydrogel sealants effectively close vitrectomy incisions and may decrease the incidence of postoperative endophthalmitis and hypotony.
Authors: Michele Coppola; Alessandro Rabiolo; Maria Vittoria Cicinelli; Giuseppe Querques; Francesco Bandello Journal: Int J Retina Vitreous Date: 2017-10-02