Take-home message: In this physician perspective, Robert J. Noecker, MD, MBA, describes the results he has experienced since he has begun applying an ocular sealant as the last step of every filtering procedure.
Fairfield, CT—Wound leakage following trabeculectomy is not an infrequent occurrence and is a potential cause of complications—such as hypotony, flat anterior chamber choroidals and endophthalmitis, if not trabeculectomy failure.1
Most studies consider leakage to occur in greater than 10% of fornix based surgeries.2
Though improved methods of wound closure can certainly decrease the probability for leakage, it is not possible to eliminate it completely.3
A sealant for clear-corneal incisions following cataract surgery has been approved by the FDA, however, and has been useful for other ocular applications.
Sealant versus glue
Glues—such as fibrin glue and cyanoacrylate—are familiar to most ophthalmologists and used in appropriate situations to hold tissues together. Sealants, on the other hand, do not have the strength to hold tissue together, but rather act to plug defects or openings in tissue, preventing the passage of fluid.