Engineering research to answer Vicryl® tie questions - 29th Apr 2017

Donald Sinclair Donald (Don) Sinclair, a final year engineering student at the University of Canterbury in New Zealand, has spent his summer finding answers to several knotty questions. The Vicryl® tie, a knot of suture material that prevents aqueous draining into the unhealed bleb for several weeks, is an important technique for achieving even better outcomes in Molteno and Molteno3 glaucoma implant surgery. The Vicryl® tie reduces hypotony and reduces fibrosis in the bleb (13, 20).

Ophthalmologists have described a variety of methods for tying the knot and occluding the tube since the technique was first described in 1986. Don's study is the first to determine whether there is any evidence to support one method over another. Working with Dr Malcolm McKellar, an experienced glaucoma surgeon, Don designed a study to investigate the effect of type of knot, size of suture material and presence of a nylon stenting suture on the force a surgeon must apply to the suture material to occlude the tube. Don also determined the forces that would damage the tube.

When the data has been analysed, Don will be able to recommend occluding techniques that produce consistent and reliable occlusion with a low risk of damaging the tube. He and Dr McKellar plan to publish the research and the results will inform the recommendations in the Molteno and Molteno3 surgical guides

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