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    No-stitch blepharoplasty: Revisiting use of tissue adhesive

    Reduced surgical time, infection among advantages but patient selection paramount

    The evolution of ophthalmic surgeries, in general, has resulted in procedures that are as safe as and less time-consuming than the original surgeries requiring suture placement, and, importantly, with outcomes that are enhanced.

    This is true for small-incision and sutureless cataract surgeries, refractive surgeries, and no-stitch blepharoplasties, said John T. LiVecchi, MD, FACS, FSEE.

    However, regarding the latter, what has become evident over time is that use of an adhesive is not the answer in all cases and appropriate patient selection is a must, said Dr. LiVecchi. He is assistant clinical professor at both Drexel University College of Medicine, Philadelphia, and the University of Central Florida College of Medicine, Orlando, chairman (emeritus), Lions Eye Institute for Transplant and Research, Tampa, FL, and medical director and partner, St. Lucy’s Eye Institute, Kissimmee, FL.

    “My original thinking was that if the procedure can be performed faster, with the potential to improve cosmesis and reduce the chances for infection, then we should work to enhance the technique,” he said.

    In addition to the rationale of shaving minutes off the procedure by eliminating the need for sutures, Dr. LiVecchi explained that using a tissue adhesive to close the wound also creates a microbial barrier between the outside and the wound—thus eliminating the need for both antibiotics and suture removal postoperatively.

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