Abstract
Purpose: :
To test a novel hydrogel sealant to secure sutureless sclerotomies under variable intraocular pressure conditions.
Methods: :
23 and 20 G sclerotomies were constructed in cadaver eyes. Sixteen 23 G beveled sclerotomies were constructed in four eyes: eight of the incisions were treated with hydrogel sealant, while eight were left bare. All sclerotomies were monitored for leaks while the intraocular pressure (IOP) was elevated. The pressure upon incision leakage was recorded as the leak pressure (max tested=140 mmHg). Additionally sixteen 20 G sclerotomies were constructed in four other eyes: eight of the incisions were treated with hydrogel sealant, while eight were sutured. These incisions were similarly pressure tested.
Results: :
23 G incisions: hydrogel sealant application to the incisions significantly increased the leak pressure relative to bare incisions, 131.8 + 8.2 vs. 39.5 + 5.2 mm Hg, respectively (p=0.000001). Only 1/8 of the sealant treated 23 G incisions leaked below 140 mmHg, compared to 8/8 of bare incision. 20 G incisions: no difference in hydrogel sealant and sutured incision leak pressure; 140 + 0 mmHg vs. 136.3 + 3.8 mm Hg, respectively (p=NS). None (0/8) of the sealant treated 20 G incisions leaked below 140 mmHg, compared to 1/8 of the sutured incisions.
Conclusions: :
Hydrogel sealant significantly increased the 23 G incision leak pressure, relative to bare incisions, and was equivalent to sutured 20 G incisions.Hydrogel sealants effectively close vitrectomy incisions and may decrease the incidence of post operative endophthalmitis and hypotony.
Keywords: vitreoretinal surgery • endophthalmitis • wound healing