EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/422211
65 EW RESIDENTS December 2014 the hydrogel and suture arms, in particular with regard to stromal hydration. If stromal hydration was used more frequently in the ReSure group, it is difficult to discern the effect of the sealant versus hydra- tion alone. A recent study by Mifflin et al. demonstrated that stromal hydration is an effective closure for wounds with 50% of wounds leaking prior to stromal hydration and none after. 8 Given this information and the frequent use of stromal hydra- tion for wound closure by cataract surgeons, it would have been useful to include stromal hydration as a standardized comparison group. A future comparison of ReSure Sealant to sutures and stromal hydration in multiplanar incisions performed by investigators with no financial interest in the treatment device would be useful in further understanding the surgi- cal benefits of a hydrogel sealant. A cost-benefit analysis should be included in this study as well. It would also be interesting to see if ReSure Sealant is helpful in com- plex cases such as those with floppy iris syndrome or wounds that leak despite stromal hydration or suture placement. Understanding the rate of fluid ingress through a cataract wound with ReSure compared to other closure methods could also more clearly demonstrate the clin- ical benefits of a hydrogel sealant. Another role for the hydrogel seal- ant may be in postoperative wound leak management, as the sealant could be applied in the office during a postoperative visit, avoiding suture placement or a return to the operat- ing room to close a persistent wound leak. While this study provides data for a promising new surgical prod- uct, the full advantages of ReSure Sealant over the current standard of stromal hydration or suture placement in multiplanar wounds is undetermined as of yet. EW References 1. Leaming DV. Practice styles and prefer- ences of ASCRS members – 2003 survey. J Cataract Refract Surg 2004;30:892–900. 2. Masket S, Hovanesian JA, Levenson J, Tyson F, Flynn W, Endl M, Parag A, Majmudar MD, Modi S, Chu RY, Raizman MB, Lane S, Kim T. Randomized comparison of a hydrogel sealant versus sutures for prevention of fluid egress following cataract surgery. J Cataract Refract Surg 2014;40:2057–2066. 3. Dell SJ, Hovanesian JA, Raizman MB, et al. Ocular Bandage Study Group. Randomized comparison of postoperative use of hydrogel ocular bandage and collagen corneal shield for wound protection and patient tolerability after cataract surgery. J Cataract Refract Surg 2011;37:113–121. 4. Masket S. et al. Use of a calibrated force gauge in clear corneal cataract surgery to quantify point-pressure manipulation. J Cata- ract Refract Surg 2013 Apr;39(4):511–8. 5. Wallin T, Parker J, Jin Y, et al. Cohort study of 27 cases of endophthalmitis at a single institution. J Cataract Refract Surg. 2005;31:735–741. 6. May WN et al. Standardized Seidel test to evaluate different sutureless cataract incision configurations. J Cataract Refract Surg 2010; 36:1011–1017. 7. Dewey S, Beiko G, Braga-Mele R, Nixon DR, Raviv T, Rosenthal K; ASCRS Cataract Clinical Committee, Instrumentation and IOLs Subcom- mittee. Microincisions in cataract surgery. J Cataract Refract Surg 2014 Sep;40(9): 1549–57. 8. Mifflin MD, Kinard K. Neuffer MC. Compar- ison of stromal hydration techniques for clear corneal cataract incisions: conventional hydra- tion versus anterior stromal pocket hydration. J Cataract Refract Surg 2012;38:933–937. Contact information Winn: bjw15@cumc.columbia.edu