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Cut and paste: a novel method of re-attaching rectus muscles with cyanoacrylate during recessions in strabismus.

Darakshan A, Amitava AK - Indian J Ophthalmol (2010 Sep-Oct)

Bottom Line: Gluing took significantly longer by 5.24+/-1.91 min (95% CI for difference: 3.87-6.61).We feel that although it takes marginally longer, iso-amyl cyanoacrylate offers an effective and safe alternative to sutures for muscle recession in strabismus surgery.Since it is cheaper (vs. polyglactin) and offers multi-use possibility it may also prove to be cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Institute of Ophthalmology, JN Medical College, Aligarh Muslim University, Aligarh, UP, India.

ABSTRACT

Aim: Bio-adhesives like cyanoacrylate offer an alternative to sutures to attach tissues, including in ophthalmology. This prospective trial evaluated the suitability and bio-tolerance of iso-amyl cyanoacrylate in rectus muscle recession surgery for strabismus.

Materials and methods: We randomized one eye in each of 10 cases of bilateral horizontal rectus recessions to 6/0 polyglactin and the other to iso-amyl-cyanoacrylate. We compared time to reattachment (from disinsertion), complications and inflammatory scores (0 to +3: nil, mild, moderate and severe) on Day One, at two and at four to six weeks post surgery.

Results: There were no significant group differences in inflammatory scores (Wilcoxon, all values of P>0.05). All attachments held firm. Gluing took significantly longer by 5.24+/-1.91 min (95% CI for difference: 3.87-6.61). There were no complications.

Conclusion: We feel that although it takes marginally longer, iso-amyl cyanoacrylate offers an effective and safe alternative to sutures for muscle recession in strabismus surgery. Since it is cheaper (vs. polyglactin) and offers multi-use possibility it may also prove to be cost-effective.

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Related in: MedlinePlus

Postoperative follow-up of the same patient: RE: sutured, LE: glued. Top row — first day; middle row, at two weeks and bottom row at 4-6 weeks
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Figure 0003: Postoperative follow-up of the same patient: RE: sutured, LE: glued. Top row — first day; middle row, at two weeks and bottom row at 4-6 weeks

Mentions: On analyzing TS on the first postoperative day a significant difference (P=0.011) was evident favoring the glued eye. The mean TS for glued eyes was 4.4 (±1.17) while for PGS it was 5.2 (±0.79), with a mean of difference 0.80 (±0.63) (95%CI for difference: 0.35-1.25). Similar analyses of TS yielded no significant differences at two weeks (95%CI: -0.25 to 0.65) and at four to six weeks (95%CI: -0.33 to 0.13). The appearance of both the eyes of one patient during follow-up is shown in Fig. 3.


Cut and paste: a novel method of re-attaching rectus muscles with cyanoacrylate during recessions in strabismus.

Darakshan A, Amitava AK - Indian J Ophthalmol (2010 Sep-Oct)

Postoperative follow-up of the same patient: RE: sutured, LE: glued. Top row — first day; middle row, at two weeks and bottom row at 4-6 weeks
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992914&req=5

Figure 0003: Postoperative follow-up of the same patient: RE: sutured, LE: glued. Top row — first day; middle row, at two weeks and bottom row at 4-6 weeks
Mentions: On analyzing TS on the first postoperative day a significant difference (P=0.011) was evident favoring the glued eye. The mean TS for glued eyes was 4.4 (±1.17) while for PGS it was 5.2 (±0.79), with a mean of difference 0.80 (±0.63) (95%CI for difference: 0.35-1.25). Similar analyses of TS yielded no significant differences at two weeks (95%CI: -0.25 to 0.65) and at four to six weeks (95%CI: -0.33 to 0.13). The appearance of both the eyes of one patient during follow-up is shown in Fig. 3.

Bottom Line: Gluing took significantly longer by 5.24+/-1.91 min (95% CI for difference: 3.87-6.61).We feel that although it takes marginally longer, iso-amyl cyanoacrylate offers an effective and safe alternative to sutures for muscle recession in strabismus surgery.Since it is cheaper (vs. polyglactin) and offers multi-use possibility it may also prove to be cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Institute of Ophthalmology, JN Medical College, Aligarh Muslim University, Aligarh, UP, India.

ABSTRACT

Aim: Bio-adhesives like cyanoacrylate offer an alternative to sutures to attach tissues, including in ophthalmology. This prospective trial evaluated the suitability and bio-tolerance of iso-amyl cyanoacrylate in rectus muscle recession surgery for strabismus.

Materials and methods: We randomized one eye in each of 10 cases of bilateral horizontal rectus recessions to 6/0 polyglactin and the other to iso-amyl-cyanoacrylate. We compared time to reattachment (from disinsertion), complications and inflammatory scores (0 to +3: nil, mild, moderate and severe) on Day One, at two and at four to six weeks post surgery.

Results: There were no significant group differences in inflammatory scores (Wilcoxon, all values of P>0.05). All attachments held firm. Gluing took significantly longer by 5.24+/-1.91 min (95% CI for difference: 3.87-6.61). There were no complications.

Conclusion: We feel that although it takes marginally longer, iso-amyl cyanoacrylate offers an effective and safe alternative to sutures for muscle recession in strabismus surgery. Since it is cheaper (vs. polyglactin) and offers multi-use possibility it may also prove to be cost-effective.

Show MeSH
Related in: MedlinePlus