Corneal wounds repair emergencies during COVID‐19: 10/0 absorbable polyglactin sutures as a valuable strategy

Abstract

PurposeThe aim of this study is to report the use of Vicryl 10‐0 (polyglactin 910) resorbable monofilament in corneal trauma during COVID‐19 pandemic: structural and functional results, and follow‐up adaptation during health crisis.MethodsDuring the COVID‐19 pandemic, nine patients were selected from the overall population of open or closed globe surgical emergencies (n = 37) in a french University Hospital. Selected patients were eligible for corneal sutures with Vicryl 10‐0, thus replacing the traditional 10‐0 nonabsorbable monofilament nylon suture. Postoperative treatment combined anti‐inflammatory drugs, topical antibiotics and lubricating drops. Outpatient visits were performed at D10, M2, M6 then every six month. Interim visits were performed if needed between D10 and M2 by teleconsultation. Patients received complete examination including different imaging. The main outcome was best corrected visual acuity. Secondary outcomes included average corneal astigmatism and the occurrence of complications.ResultsMean distance and near acuity improved from 0.711 ± 0.805 & 0.556 ± 0.305 logMAR preoperatively to 0.056 ± 0.073 & 0.333 ± 0.100 logMAR postoperatively (p = 0.032 and p = 0.043 respectively). Mean astigmatism decreased from 4.91 ± 4.21 diopters preoperatively to 0.99 ± 0.57 after suture resorption (p = 0.020). There were no serious adverse events or repeated surgery.ConclusionsPolyglactin 910 10‐0 could provide a maximum infectious risk reduction; a shorter topical treatment and antibiotic prophylaxis. The absorbable nature of the sutures simplifies logistics by reducing the number of early outpatient visits before M2. It avoids suture removal, especially for the pediatric population. Interim teleconsultation(s) on demand are interesting to evaluate the need for an additional face‐to‐face consultation. Vicryl 10‐0 sutures are ideally suited to the COVID‐19 pandemic logistical constraints, as a safe and effective alternative to nylon 10‐0 for the management of eligible corneal wounds.