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    Ocular sealant proves effective for routine, unexpected cases

    Agent migrates to areas that do not have epithelium attached; eye must be dry for adherence


    In addition, the sealant group tended to have less discomfort and pain postoperatively, with six patients reporting symptoms in the sealant group and 24 patients reporting symptoms in the sutures-only group. Hydrogel materials have long been used in soft contact lenses, and it is likely the sealant acts in a similar way to provide additional comfort. There was no significant difference in IOP at 3 months between the groups.


    1. Van Buskirk EM. Five-year follow-up of the Fluorouracil Filtering Surgery Study. Am J Ophthalmol. 1996;122:751-752.
    2. Kirk TQ, Condon GP. Modified Wise closure of the conjunctival fornix-based trabeculectomy flap. J Cataract Refract Surg. 2014;40:349-353.
    3. Solus JF, Jampel HD, Tracey PA, et al. Comparison of limbus-based and fornix-based trabeculectomy: success, bleb-related complications, and bleb morphology. Ophthalmology. 2012;119:703-711.


    Robert J. Noecker, MD, MBA

    E: [email protected]

    Dr. Noecker is in practice with Ophthalmic Consultants of Connecticut, Fairfield, CT, and is assistant clinical professor, Yale University School of Medicine, New Haven, CT.


    Surgical experience with a versatile tool

    The most common use of the sealant for Robert J. Noecker, MD, MBA, is in conjunction with sutures during routine trabeculectomies or mini-shunt (EX-PRESS, Alcon Laboratories) filtering surgeries. However, he said it is helpful in a variety of situations:

    • The sealant can be used when the surgeon needs to stop the flow of aqueous, such as when there is too much flow postoperatively with a scleral incision.
    • In a routine setting, endocyclophotocoagulation is performed through a 2.4-mm pars plana incision in the sclera. Rather than suturing, a sealant is used.
    • With any kind of tube shunt, there is sometimes leakage around the tube, which can lower IOP excessively. The sealant can be used to close up any excess around the tube.
    • In patients with hypotony or excessive flow of aqueous, it is possible to apply the sealant to the sclera and shut down the flow.
    • If a patient develops a late leak, the sealant can be used in the surgeon’s office. “I had a patient with a late bleb leak and I directly rubbed the area of the bleb with a Weck cell sponge to wipe off the epithelium and then applied the ReSure Sealant,” Dr. Noecker said. “I covered this with a contact lens and left it there for one week.”
    • Usually with late leaks, the tissue around the suture is not the best quality and additional sutures can cause additional leaks. Using the sealant can really save you.
    • The sealant is also valuable in trauma situations where someone gets an irregular laceration in the cornea. If the area can be kept dry, the sealant can be applied.


    Robert J. Noecker, MD
    Dr. Noecker, vice chair, University of Pittsburgh Medical Center Eye Center, and director, Glaucoma Service and associate professor of ...

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