He reported a 94% success rate with the no-stitch procedure. Analysis of the first and follow-up studies showed a total of 11 gapes and two toxic reactions to the adhesive on two eyelids of one patient.
Importantly, no infections developed in any patients despite that no antibiotic ointment was used, even those with an adverse effect.
Allergic reactions are not a major problem with the tissue adhesive, in that an estimated 1% to 2% of patients have a reaction.
Despite the high success rate with no-stitch blepharoplasty and the seeming simplicity of the procedure, Dr. LiVecchi—who has performed in excess of 25,000 oculoplastic procedures during his career—noted that he no longer uses the tissue adhesive as his first choice for wound closures.
“I originally thought that use of a tissue adhesive was indeed a progressive and advantageous step for closing blepharoplasty incisions and would eliminate suturing completely,” he said. “I was extremely excited about the prospect of eliminating sutures and the additional inherent benefits.
John T. LiVecchi, MD, FACS, FSEE
E: [email protected]
This article was adapted from Dr. LiVecchi’s presentation at the American Academy of Ophthalmology. Dr. LiVecchi is editor of the Ophthalmology Times “Plastic Pearls” column and a member of its editorial advisory board. He has no proprietary interest in the subject matter.