Hydrogel sealant may be better than sutures for preventing leakage

This prospective study found that hydrogel sealant was safe and effective and better than sutures for intraoperative management of clear corneal incisions and for preventing postop fluid leakage.

We found that the sealant clearly did a better job of keeping incisions closed than sutures. As one of the study's authors, I wouldn’t suggest using the sealant for every case, but I believe it does have a role at every surgery center for difficult cases.

We assessed would leakage in 500 patients undergoing clear corneal incision cataract surgery. We found spontaneous leakage using a Seidel test on the main clear corneal incision was in 244 eyes (48.8%). Among the remainder, we applied up to 1 ounce of force using a calibrated force gauge, bringing the total number of eyes with leakage to 488 (97.6%). We randomized these eyes to treatment with the hydrogel sealant (Resure) or a nylon suture at the main incision site. 

During the week after surgery, 12 eyes (4.1%) in the sealant group and 60 eyes (34.1%) in the suture group had wound leakage using the Seidel test or calibrated force gauge. Also, the overall incidence of adverse ocular events was significantly lower in the sealant group than in the suture group (P < 0.05).

Use of the hydrogel sealant eliminated the need for an office visit for suture removal and eliminated minor adverse events, such as subconjunctival hemorrhage and discomfort that can occur with sutures.