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用于青光眼联合手术中透明角膜切口闭合的水凝胶密封剂

Hydrogel Sealant for Closure of Clear Corneal Incisions in Combined Glaucoma Procedures.

作者信息

Machiele Ryan D, Guduru Abhilash, Herndon Leon W

机构信息

Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, USA.

Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA.

出版信息

Clin Ophthalmol. 2022 Mar 19;16:861-865. doi: 10.2147/OPTH.S354531. eCollection 2022.

Abstract

PURPOSE

The purpose of this study is to determine whether ReSure hydrogel sealant is superior to standard suture for closure of clear corneal incisions in the setting of combined glaucoma procedures.

SETTING

Glaucoma Department, Duke University Eye Center.

DESIGN

This is a retrospective case series. Subjects studied were patients in a 6-year period undergoing combined phacoemulsification and glaucoma surgery. All cases were performed by the same surgeon. Wound closure methods correlated with discrete timeframes, as ReSure replaced suture midway through the study period, thereby establishing sutured closure as an analogous control group.

METHODS

All cases included a phacoemulsification procedure requiring a 2.4 mm clear corneal incision. Upon completion of the phacoemulsification portion of the case, the wound was closed with either ReSure hydrogel or standard 10-0 suture closure. The researchers assessed the rate of Seidel-positive corneal wound leak on postoperative day one.

RESULTS

In all cases employing ReSure, no wound leak was observed at postoperative day one. Within the suture group, 3 cases showed Seidel positivity of the corneal incision. This equates to a statistically significant difference in wound leak frequency of 2.04% (P = 0.012); confidence interval, 0.21 to 5.82.

CONCLUSION

ReSure was able to maintain closure 100% of the time over hundreds of combined cases. Suture, though the standard of practice, did not perform to this level, presenting with 3 cases of spontaneous wound leak. We conclude that ReSure is highly effective and superior to suture in closure of clear corneal incisions in combined glaucoma procedures.

摘要

目的

本研究旨在确定在联合青光眼手术中,ReSure水凝胶密封剂在闭合透明角膜切口方面是否优于标准缝线。

地点

杜克大学眼科中心青光眼科。

设计

这是一项回顾性病例系列研究。研究对象为6年间接受白内障超声乳化吸除联合青光眼手术的患者。所有病例均由同一位外科医生实施。伤口闭合方法与不同时间段相关,因为在研究期间中途ReSure取代了缝线,从而将缝线闭合作为一个类似的对照组。

方法

所有病例均包括一个需要2.4毫米透明角膜切口的白内障超声乳化吸除手术。在病例的白内障超声乳化吸除部分完成后,伤口用ReSure水凝胶或标准10-0缝线闭合。研究人员评估术后第一天角膜伤口渗漏的Seidel阳性率。

结果

在所有使用ReSure的病例中,术后第一天均未观察到伤口渗漏。在缝线组中,有3例角膜切口显示Seidel阳性。这相当于伤口渗漏频率在统计学上有显著差异,为2.04%(P = 0.012);置信区间为0.21至5.82。

结论

在数百例联合病例中,ReSure能够100%保持伤口闭合。缝线虽是常规做法,但未达到这一水平,出现了3例自发性伤口渗漏。我们得出结论,在联合青光眼手术中,ReSure在闭合透明角膜切口方面非常有效且优于缝线。

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