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    No-stitch blepharoplasty: Revisiting use of tissue adhesive

    Reduced surgical time, infection among advantages but patient selection paramount

     

    Over two decades, Dr. LiVecchi’s idea has moved from the use of a medical grade “crazy glue” off-label to secure silicone stent knots in dacryocystorhinostomies and as a temporary tarsorrhaphy in adults, uncooperative children, and for one blepharoplasty.

    A 2-octyl, cyanoacrylate, topical skin adhesive (SurgiSeal, Adhezion Biomedical) was a step forward for patients undergoing blepharoplasty. The adhesive was as strong as or stronger than 5.0 sutures, flexible, less exothermic than other topical skin adhesives, and acted as a microbial barrier.

    Dr. LiVecchi tested the adhesive in an initial study that included 100 eyelids and a retrospective follow-up study that included 180 eyelids (90 patients; average age, 66.5 years).

    The adhesive was delivered using an applicator (SurgiSeal Stylus, Pfizer) to promote effective application of the adhesive on the eyelid and prevent the adhesive from running off the eyelids into the eyes.

    The adhesive provided wound closure that is equivalent to a 5.0 suture or 7 days of healing, Dr. LiVecchi noted.

    Success rate

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