Eyeworld

EW CATARACT 41 September 2014 who I think are good candidates," Dr. Kim said. You also have to con- sider patient risk factors. Patients who are having trouble putting in their drops and may be rubbing their eyes as well as those who are mentally disabled are likely prime candidates, he noted. In addition, monocular patients, those who have MRSA, or those who are immu- nocompromised could benefit, Dr. Kim said. Instances in which the femtosecond laser is used for cataract surgery may provide an ideal opportunity for this product. "There have been some reports of surgeons not being able to close the incision at the end of the case with stromal hydration with the femto- second laser," he said. However, use of this may be most impactful off-label on DSEK patients, Dr. Kim thinks. Because it is such a large wound (typically 4–5 mm), a suture is ultimately placed. Unfortunately, this can compromise the air bubble used for the DSEK technique, he finds. "During the suture placement, the air typically escapes very quickly, the cham- ber collapses, and the graft either dislocates or touches the iris and the lens," Dr. Kim said. "So, there's trauma to the endothelium." Use of the ReSure Sealant has changed the way Dr. Kim approach- es his DSEK cases. "At the end of my DSEK, I put the air bubble in, have the graft nicely centered, then I put the ReSure Sealant right on the 4.1 mm wound and inflate the eye to the normal high pressure and let it sit for 8 minutes," he said. "I do the venting incisions, lower the pressure, and put some balanced salt solution into the anterior chamber while the sealant securely seals the wound." He finds this allows him to complete the procedure without running the risk of traumatizing the graft or inducing astigmatism due to a suture. Overall, Dr. Kim views use of the ReSure Sealant to prevent wound leaks as akin to routinely wearing a seatbelt in a car. "That's the thing we learned from this clinical study—the wound leak rates are high," he said. "The problem is you don't know which of these cases is going to end up with endophthalmitis, epithelial downgrowth, or IOL dislocation," he said. He encourages practitioners to take the approach of using some- thing that is going to add security in terms of wound sealing. "I think this is an approach that more and more surgeons will look at once they realize that their wounds could be leaking more often than they think," he said. EW Editors' note: Dr. Kim has financial interests with Ocular Therapeutix. Contact information Kim: terry.kim@duke.edu Cataract Retinal Refractive Glaucoma Corneal Ocular Surface Disease Oculoplastic Beaver-Visitec International, Inc. | 411 Waverley Oaks Road Waltham, MA 02452 USA | Merocel trademark is the property of Medtronic Xomed, Inc. BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of a Beaver-Visitec International ("BVI") company © 2014 BVI For more information, call 1.866.906.8080 or visit us at www.beaver-visitec.com Keeping your vision in sight with the most trusted brands in your ophthalmic specialty Beaver ® Visitec ® Merocel ® Parasol ® Wet-Field ® Atomic Edge ® Accu-Temp ® Osher ThermoDot ® Readypak ™ CustomEyes ® And More! Come See What's New! Visit AAO booth #2321

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