Why do I use TISSEEL fibrin adhesive with eyelid surgery? – Part 1
TISSEEL fibrin adhesive stimulates the fibrin cascade which is an essential part of healing after eyelid surgery. With upper eyelid surgery such as blepharoplasty and ptosis, the use of TISSEEL fibrin adhesive greatly assists the surgeon and the patient.
It means that fewer sutures are required in the eyelid when the TISSEEL fibrin adhesive is used instead, with fewer stitches required to close up the edges of the skin. It also helps to seal the spaces inside the eyelid by promoting the fibrin clot. This gives a much quieter eyelid post-surgery. Although there is often less bruising and swelling with the use of TISSEEL fibrin adhesive with eyelid surgery, bruises will still occur, particularly in older patients.
The use of TISSEEL fibrin adhesive with upper eyelid surgery is a well-established procedure. I have been doing this for 15 years since approximately 2003, and I have used it on more than 580 patients.
I carry out upper eyelid surgery under local anaesthetic as a day case and the use of TISSEEL fibrin adhesive also shortens the length of time that the patient has to lie flat for the surgery. This is because there are fewer stitches to put in and so it is a more comfortable and pleasing experience for the patient.
After upper eyelid surgery where I have used TISSEEL fibrin adhesive, I do not usually have to pad the eyes. If I pad the eyes, it is only going to be for one hour while the patient is in recovery. Then I take the pads off, and the patient can go home without any eye pads.
After the use of TISSEEL fibrin adhesive, the eyelid care is slightly different, to the extent that I like the patient to wear a Cartella plastic transparent shield over their eye at night. This stops them from accidentally rolling their face into the pillow and having eyelid-to-pillow touch, which could theoretically affect the wound, particularly if there are few stitches and the delicate TISSEEL fibrin adhesive. The patient can use ice packs, but I do not like them to apply any pressure on to the eyelid during the first week, and so the ice packs must be held very lightly.