No-Stitch Blephroplasty
Purpose
To advance the audience's knowledge on the safety and efficacy of a new procedure using 2-octyl cyanoacrylate by demonstrating a reduced time to perform a blephroplasty without compromising the integrity of the incision, and to show a reduced opportunity of infection and eliminating the need for antibiotic ointments post operatively, and to improve cosmesis.
Methods
This is a retrospective study of the first 100 eyelids and 50 patients with the mean age of 71 y/o(48-83 y/o). All patients had clinically significant dermatochalasis with hooding confirmed by visual fields, marginal reflex distance (MRD), photos, subjective and objective findings. Patients with potential non-compliance issues such as early onset dementia, uncooperative patients and patients with unrealistic expectations were excluded to the best of my knowledge at the time of consultation. Immunocompromised or very sick patients were not consulted. A comparative analysis was done on early patients, suturing one eyelid and using 2-octyl cyanoacrylate on the contralateral eyelid of the same patient.
Results
The results demonstrated a 97% success rate with interference from the learning curve. Within the the first 10 eyelids of the study, 3 eyelids gaped from using too much glue in the beginnig (more is not better) and an unrecognized preop non compliant patient. After the learning curve, all patients subsequent to the initial groups outcome were successful without complications or side effects. Even with no antibiotic ointment used, there were no infections in 100% of the patients including the eyelids that gaped due to the microbial barrier of 2-octyl cyanoacrylate tissue adhesive.
Conclusion
Stitchless blephroplasty using 2-octyl cyanoacryolate is a safe and efficacious procedure as an alternative to sutured blephroplasties with the advantage of reduced surgery time, reduced PO infection, the elimination of antibiotc ointments PO, elimination of suture removal with its suture tracks and the potential for better cosmesis.