This paper reports a prospective randomised controlled trial of patients undergoing routine phacoemulsification with a 2.75mm clear corneal incision and followed up for 14 days postoperatively. They evaluated wound edge closure, surgically induced astigmatism and foreign body sensation after use of single 10/0 nylon suture or a liquid adhesive bandage compared to a control group with only stromal hydration. Patients with>0.5D astigmatism had on-axis surgery with the rest having a temporal incision, but the impact of incision site and pre-existing astigmatism was not explored across groups. Suturing was associated with the most surgically induced astigmatism (mean 1.3D) than the adhesive and control groups (mean 0.6D each) with no significant change across groups over 14 days. The adhesive group has the least foreign body sensation on visual analogue scores, followed by control group, with the highest being with suture use. The Siedel test was negative in all patients although wound edge closure assessed by fluorescein staining of wound edge was worst with hydration only. An adhesive to aid wound integrity postoperatively is an important tool in our armamentarium but the need in routine cataract surgery may not be adequately justified both in terms of time and cost. The adhesive would need evaluation in more complex cases where there is risk of wound gaping (corneal pathology / burn) or even in a wider range of intraocular procedures.
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