Use of Sealant as Adjunct to Conjunctival Closure in Filtering Surgery

Monday, April 20, 2015: 1:01 PM
Room 1A (San Diego Convention Center)
Robert J. Noecker, MD, MBA

Purpose
To evaluate the efficacy of Resure sealant as an adjunct to suture closure of conjunctiva in glaucoma filtering surgery to determine its role for use in minimiizing post-operative leaks and hypotony.

Methods
A retrospective consecutive case series of 15 filtering surgeries in which the Resure sealant was used in conjunction with sutures for fonix based conjunctival closure was compared to 15 prior consecutive cases in which no sealant was used.  Sealant was applied at the end of the case after suturing in those patients undering surgery.  Consecutive Patients who had not undergone prior conjunctival surgery and who were undergoing filtering surgery were included.  The primary endpoint of evaluation was the presence of postoperative leaks. Secondary measures were IOP, patient comfort, refractive outcome, and postoperative interventions.

Results
No patients who received Resure in conjunction with sutures experienced post-operative wound leaks.  In the control group, without Resure, one patient  (1/15) had a wound leak which resulted in hypotony (p= 0.50).  Mean IOP was slightly higher in the Resure group in the first week 10.0 versus 8.1 mm Hg.  Patient comfort in the first week was slightly higher in the Resure group as well.

Conclusion
Resure sealant appears to be an effective adjunctive agent for conjunctival closure with sutures in filtering surgery.  In this retrospective series, it was safe and well tolerated and was associated with no postoperative leaks.