Tissue adhesives are gaining popularity in ophthalmology, as they could potentially reduce the complications associated with current surgical methods. An ideal tissue adhesive should have superior tensile strength, be non-toxic and anti-inflammatory, improve efficiency and be cost-effective. Both synthetic and biological glues are available. The primary synthetic glues include cyanoacrylate and the recently introduced polyethylene glycol (PEG) derivatives, while most biological glues are composed of fibrin. Cyanoacrylate has a high tensile strength, but rapidly polymerises upon contact with any fluid and has been associated with histotoxicity. Fibrin induces less toxic and inflammatory reactions, and its polymerisation time can be controlled. Tensile strength studies have shown that fibrin is not as strong as cyanoacrylate. While more research is needed, PEG variants currently appear to have the most promise. These glues are non-toxic, strong and time-effective. Through MEDLINE and internet searches, this paper presents a systematic review of the current applications of surgical adhesives to corneal, glaucoma, retinal, cataract and strabismus surgeries. Our review suggests that surgical adhesives have promise to reduce problems in current ophthalmic surgical procedures.
PURPOSE:
To report the outcomes of a series of 16 patients who had secondary surface ablation within 4 weeks of an aborted femtosecond laser–assisted in situ keratomileusis (FS-LASIK) procedure.
METHODS:
A retrospective chart review of electronic medical record data from 2011 to 2015 was performed to identify eyes of patients who had an aborted FS-LASIK procedure followed by secondary surface ablation (photorefractive keratectomy or laser epithelial keratomileusis) within 4 weeks of the primary procedure. Patients were required to have at least three postoperative visits to be included in the study.
RESULTS:
The review identified 20 aborted FS-LASIK procedures of 7,142 eyes (0.003%), of which 16 met the inclusion criteria. The most common reasons for abortion were incomplete (10) and decentered (3) flaps. Thirteen of 16 eyes were treated within 2 weeks. A total of 11 of 16 eyes achieved uncorrected distance visual acuity (UDVA) of 20/20, 13 of 16 achieved UDVA of 20/25 or better, and 15 of 16 had a corrected distance visual acuity (CDVA) of 20/20. There were no intraoperative complications during the second procedure and there were no cases of diffuse lamellar keratitis. One patient developed postoperative haze with a CDVA of 20/25 and was lost to follow-up.
CONCLUSIONS:
This case series indicates that early surface ablation (within 4 weeks) after an aborted FS-LASIK procedure may be performed with good visual outcomes.
[
J Refract Surg
. 2019;35(2):121–125.]
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