Sealing NPDS Flap with Fibrin Glue
Dr. Lewis utilizes TISSEEL glue to seal the scleral flap following non-penetrating deep sclerectomy and collagen implant surgery. All four cases included implantation of an AquaFlow Collagen Glaucoma Drainage Device (STAAR Surgical, Monrovia, CA).
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Comments (6)
I've perforated a few times. When that happens, the glue doesn't work so well! My strategy now is, don't perf.
??does not depend on subconj absorption? that cant be right- where is the aqueous going?
The staff and the patients are happy! No more foreign body sensation. I have had no loss in effectiveness either in NPDS or in Ahmed valves. Great time and aggravation saving step.
looks good and would definitely make the staff happy!..is there any chance of the glue blocking the lumen of the stent in your experience
The glue does indeed stick the conjunctiva to the flap. I have only used this technique with tube shunts and Staar's AquaFlow shunt which do not depend on subconjunctival absorption. Others who perform standard and mitomycin trabs will have to address the rest of your answer.
How does the glue not cause the conjunctiva to also adhere to the scleral flap (rather than just limbus), therefore no bleb? I wound think you would have a flat bleb since you just put glue on the conjunctiva and flap and then sealed the two together?