Evaluation of Efficacy of Sealant in Management of Postoperative Wound Leak Post DSAEK
To evaluate the use of ReSure Sealant in post Descemet stripping automated endothelial keratoplasty (DSAEK) and its efficacy in the management of post-operative wound leak.
Prospective case series of 19 patients undergoing uncomplicated DSAEK with a 3.75mm clear corneal incision (CCI). A CCI is initially created in a tri-planar fashion with a 2.4mm keratome and enlarged to 3.75mm (sharp point implant blade). DSAEK grafts are inserted using an Endoserter technique. Following graft positioning and air-fluid exchange, the CCI is stromally hydrated. A calibrated force gauge is used to apply 1 oz of external force, and fluorescein is used to assess wound leak. ReSure sealant is then applied to the wound, and rate of wound leakage is compared between stromal hydration and ReSure sealant.
Of 19 patients, 6 cases (31.6%) had spontaneous leakage, 7 cases (36.8%) had leakage with application of 1 oz external force. Only 3 cases (15.8%) had leakage with provocation after placement of the ReSure sealant.
ReSure sealant is a viable method to help ensure adequate wound sealing with sutureless DSAEK with no adverse events reported in this study.