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An ocular bandage that has been on the market in Europe for several years is receiving praise from clinicians familiar with the product. Matteo Piovella, MD, has been using the bandage on every eye he has operated on for the past 4 years.
San Francisco-An ocular bandage that has been on the market in Europe for several years is receiving praise from clinicians familiar with the product.
Matteo Piovella, MD, director of the Centro di Microchirurgia Amgulatoriale, Monza, Italy, said he has been using the liquid bandage (OcuSeal, Beaver-Visitec) on every eye he has operated on for the past 4 years.
“We are using [the bandage] routinely, in every single case, for the last 4 years,” Dr. Piovella said. “I would not return back to surgery without this liquid bandage.”
The bandage is a synthetic hydrogel that is 80% water, he continued. It is made of two components: powered polyethylene glycol and liquid polyethylene amine. The two components are packaged separately and are snapped together at the surgical table, shaken for 5 seconds, and immediately applied to the ocular surface. The gel cross-links within 30 seconds to form a smooth, flexible, transparent barrier film that seals and protects the incision.
For the research presented at the 2013 meeting of the American Society of Cataract and Refractive Surgery, surgeons used the liquid bandage to reinforce closure of clear corneal incisions up to 3.75 mm in length in 217 eyes of 161 patients. The biggest problem, Dr. Piovella noted, was learning to mix and apply the liquid rapidly. The label suggests an application period of 15 seconds after mixing, but he noted that 10 seconds is a more practical time limit. About 2% of packages had to be replaced after the hydrogel cross-linked and set up before it could be applied.
“This is just a learning curve,” he said. “With experience, we have come to understand that we need 5 seconds of vigorous shaking and then we have 10 seconds to apply the bandage. With just a little bit of practice, it is not a problem to prepare and use.”
Applying too much gel has not been a problem, he continued. Any surplus gel disappears within 12 hours due to normal eyelid movement, leaving a smooth, clear film to seal the wound. About 15% of patients report feeling a foreign body in the eye one day after surgery compared with more than 70% of patients using conventional wound closure. The entire hydrogel bandage absorbs and disappears within 3 days.
“These results support the routine use of hydrogel bandages for cataract surgery,” Dr. Piovella said.
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