MARCH 2014
Khaas Baat : A Publication for Indian Americans in Florida
Guest Column

Glues in Eye surgery: A No-Stitch future is a reality


The U.S. Food and Drug Administration (FDA) recently approved to commercialize a special glue for use in eye surgery.

In an organ as delicate as the eye, where every action of the surgeon, including stitching can takes away from the final vision endpoints, a minimalistic and elegant approach has always been a consistent quest.

The ideal characteristics for a tissue glue would be; easy to apply, non-reactive, comfortable for the patient, and doesn’t require removal following surgery. Additionally, if the glue also proves to be stronger that stitches then we have the best of both worlds. This newly approved, polyethylene glycol-based (PEG) hydrogel is applied as a liquid and gels on the surface of the eye in less than 20 seconds.

The immediate application could be in the most common eye surgery performed worldwide, i.e., cataract surgery; 3.5 million/year. Presently, eye surgeons use stromal hydration to close cataract surgery wounds (if not using stitches). However, recent reports in the literature suggest that in some cases, this method of wound closure may not be adequate to provide a watertight seal and hence may lend to leakage of the incision and also an entry point for bugs raising the chance of infections postoperatively.

Besides these stitches also induce astigmatism (imagine creating an uneven shape because of hand-stitching on the cornea) as explained in my previous articles (Khaasbaat).

Applications of glue then become universal in eye surgery to provide an elegant and aesthetic closure with safety from infection and retaining best vision by avoiding astigmatism.

Cataract surgery can then be raised to new levels of expectations with patients may be returning to work same day or playing golf and travelling next day and bending or lifting (without having to restrict themselves as they do now for a week to two weeks). Not only then can we use modern laser techniques for cataract surgery along with Multifocal (progressive) lens implants to aim for perfect vision without glasses but also let the patient get back to life earlier with higher confidence

Glues can further be used in those cases of cataract surgery that could not have a lens implant by gluing the lens in place permanently.

In pterygium surgery (to remove the red growth from the white of the eyes), glued human placenta can be used to heal the operated area comfortably and predictably.

Use of stitches on the beautiful eyeball never made sense to me even as a student and I am glad that we have finally evolved out of that connection into the “suture-free” era.

Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at or visit 

College Admissions and Tests: Truth vs. Fiction

By Robert A.G. LeVine

Many people believe that a perfect 800 SAT score is the key to gaining admission to America’s highly selective colleges. This is a fallacy.

Although it is true that higher scores and grades are more beneficial than lower ones, and that state and local colleges focus on “numbers” more than anything else, highly selective colleges look at admissions from a broader perspective.

Premier colleges evaluate applicants in three areas: academics, activities and personal qualities. Although SAT and ACT scores and school grades are the starting point for evaluating academic potential, they are not the only things considered. Research, publications, competitions, honors and other academic indicators – including SAT Subject Tests and AP tests – are used to adjust an applicant’s “academic” rating.

Right now, high school juniors are focused on taking SAT and ACT tests.

Most colleges don’t care which test an applicant takes; you can submit scores from either test, and there is no advantage to taking both. The colleges will look only at an applicant’s highest scores, so it is highly recommended that students take a college admissions test more than once, to achieve the highest possible score.

Applicants should also understand “super-scoring.” If a college accepts super-scoring, it will consider only the highest scores in each individual section of the test, regardless of when the test was taken. For example, if a student achieves a high math score on the January SAT, but the highest reading score comes from a May SAT, the colleges will super-score the results and consider only the January math and May reading scores.

Not all colleges will super-score. Today, most of the highly-selective colleges do super-score the SAT, but not the ACT. Some will super-score both; some won’t super-score at all. The admissions websites of each college explain their testing policies.

Beyond super-scoring, are there differences between the SAT and ACT?

Regardless what the official websites say, both the SAT and ACT are based on logic and reasoning even more than on substance. Test results are largely dependent upon an ability to understand the test questions, not just what is taught in school. On the math section, the ACT is commonly considered to be more “valid” – testing formulas and actual math – than is the SAT. This can be a good or bad thing, depending upon a student’s strengths and test methods.

Because both tests evaluate an applicant’s ability to answer questions, applicants should study HOW the test questions are written. College admissions tests do not “reinvent the wheel” with every new test; they repeat the same question formats, with different specifics, to ensure the validity of each test. Private test tutors do a better job of “teaching the questions” than do most institutional instructors.

Finally, remember that selective colleges review ALL of an applicant’s academic achievements. Scores on AP exams and SAT Subject Tests can raise or lower an “academic” grade significantly. Low AP scores often raise red flags about a student’s true academic potential, so prepare for all tests seriously.

Robert A.G. LeVine, president of Selective College Consulting, Inc., can be reached at (813) 391-3760, or email or visit

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