Authors: David Plemel ¹, Wendy Ming², Karim Punja².  ¹University of Calgary & University of British Columbia, ²University of Calgary.

Author Disclosures:  D. Plemel:  None.  W. Ming:  None.  K. Punja:   Membership on advisory boards or speakers’ bureaus; Name of for-profit or not-for-profit organization(s); Alcon Canada Inc, Allergan Inc, Clarion Medical Technologies.

Abstract Body: 

Purpose:  Assess the effect of fibrin sealant (Tisseel) on post-operative bruising after upper eyelid blepharoplasty.  

Study Design:  Prospective randomized control trial.  

Methods:  Patients undergoing bilateral upper eyelid blepharoplasty had the eyelids randomized with an equal 1:1 intervention to control allocation ratio. The control group underwent standard blepharoplasty closure only. The intervention group received fibrin sealant in the wound in addition to standard blepharoplasty closure. Photographs were taken by the patient on post-operative days one, three, and seven. Photographs were assessed by two blinded ophthalmic surgeons who graded the degree of ecchymosis on each side using a Likert scale.  

Results:  Forty-five patients were recruited for this study. The intervention group had less bruising, with a lower grade on the Likert scale compared to the non-fibrin sealant side, on postoperative days 3 and 7 but not day 1. Subgroup analysis of patients normally on blood thinners (antiplatelet or anticoagulant therapy) showed that fibrin sealant did not result in a statistically significant decrease in ecchymosis. Whereas the group not normally on blood thinners had decreased bruising on postoperative days 3 and 7 but not on day 1.  

Conclusions:  Fibrin sealant reduces post-operative bruising after upper eyelid blepharoplasty. Fibrin sealant does not improve bruising in patients who are normally on blood thinners.