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Effect of fibrin glue as an adjuvant to hang-back surgery.

Park J, Lee JJ, Lim EH, Lee JH, Jin KH, Kim US - BMC Ophthalmol (2012)

Bottom Line: The aim of this study is to determine the stabilizing effects of fibrin glue as an adjuvant to hang-back surgery.The frequency of stable insertion of the recessed muscle at the intended site was greater in the fibrin glue group (9 eyes) compared to the control group (3 eyes) (p=0.028).Fibrin glue is effective in stabilizing the new rectus muscle insertion and decreasing the displacement in the hang-back surgery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.

ABSTRACT

Background: The hang-back surgery is a useful technique in the field of strabismus surgery. The aim of this study is to determine the stabilizing effects of fibrin glue as an adjuvant to hang-back surgery.

Materials and methods: Four (4)-mm hang-back recessions of the superior rectus muscle was performed in 32 eyes of 16 rabbits. Only in the left eye of the 16 rabbits, fibrin glue was applied between the recessed muscle bed and the sclera at the end of hang-back surgery (fibrin glue group). After 6 weeks, we compared the stability of the recessed rectus muscle between the fibrin glue group and the control group by evaluating the displacement of the muscle.

Results: The frequency of stable insertion of the recessed muscle at the intended site was greater in the fibrin glue group (9 eyes) compared to the control group (3 eyes) (p=0.028). In the control group, 5 eyes showed anterior displacement and 8 eyes showed posterior displacement and in the fibrin glue group, 1 eye showed anterior displacement, and 6 eyes showed posterior displacement. Anterior displacement was more common in the control group (6.3% Vs 31.3%). The control group and the fibrin glue group showed similar histological findings on microscopic examination.

Conclusions: Fibrin glue is effective in stabilizing the new rectus muscle insertion and decreasing the displacement in the hang-back surgery.

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Related in: MedlinePlus

Gross appearance immediately after (A,B) and 6 weeks after (C,D) surgery. Conventional hang-back recession was performed on the superior rectus muscle of the both eyes, and one side was remained without any manipulation (A) and fibrin glue was applied between superior rectus muscle bed and the sclera only in the left eye (B) . After 6 weeks, the distance between the original and the new insertion site was grossly measured (C,D).
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Figure 2: Gross appearance immediately after (A,B) and 6 weeks after (C,D) surgery. Conventional hang-back recession was performed on the superior rectus muscle of the both eyes, and one side was remained without any manipulation (A) and fibrin glue was applied between superior rectus muscle bed and the sclera only in the left eye (B) . After 6 weeks, the distance between the original and the new insertion site was grossly measured (C,D).

Mentions: All surgeries were done by one skilled strabismus surgeon. The superior rectus muscle was exposed through a limbal incision, and two locking bites were placed at each edge of the muscle near its insertion site with double-armed 6–0 coated vicryl (Ethicon®, New Jersey, USA). After the muscle was separated from the globe, two needles were passed through each end of the original scleral insertion, with the needles pointing toward the center of the insertion site. The muscle was pulled back and placed 4 mm posterior to the original insertion site, and the knot was tied. Then in the right eye (control group), conjunctival suturing was done without an additional procedure, and in the left eye (fibrin glue group), small amount (about 0.02 ml: 0.01 ml from each syringe) of fibrin glue (Greenplast kit®, Green cross, Gyeonggi-do, Korea) was applied between the recessed muscle and the sclera. Human fibrinogen concentrate and thrombin were loaded into each syringe and were simultaneously injected through Y-piece and application needle (Figure 1). After a two-minute wait to allow for glue hardening, conjunctival suturing was done, as in the right eye (Figure 2a, b).


Effect of fibrin glue as an adjuvant to hang-back surgery.

Park J, Lee JJ, Lim EH, Lee JH, Jin KH, Kim US - BMC Ophthalmol (2012)

Gross appearance immediately after (A,B) and 6 weeks after (C,D) surgery. Conventional hang-back recession was performed on the superior rectus muscle of the both eyes, and one side was remained without any manipulation (A) and fibrin glue was applied between superior rectus muscle bed and the sclera only in the left eye (B) . After 6 weeks, the distance between the original and the new insertion site was grossly measured (C,D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473302&req=5

Figure 2: Gross appearance immediately after (A,B) and 6 weeks after (C,D) surgery. Conventional hang-back recession was performed on the superior rectus muscle of the both eyes, and one side was remained without any manipulation (A) and fibrin glue was applied between superior rectus muscle bed and the sclera only in the left eye (B) . After 6 weeks, the distance between the original and the new insertion site was grossly measured (C,D).
Mentions: All surgeries were done by one skilled strabismus surgeon. The superior rectus muscle was exposed through a limbal incision, and two locking bites were placed at each edge of the muscle near its insertion site with double-armed 6–0 coated vicryl (Ethicon®, New Jersey, USA). After the muscle was separated from the globe, two needles were passed through each end of the original scleral insertion, with the needles pointing toward the center of the insertion site. The muscle was pulled back and placed 4 mm posterior to the original insertion site, and the knot was tied. Then in the right eye (control group), conjunctival suturing was done without an additional procedure, and in the left eye (fibrin glue group), small amount (about 0.02 ml: 0.01 ml from each syringe) of fibrin glue (Greenplast kit®, Green cross, Gyeonggi-do, Korea) was applied between the recessed muscle and the sclera. Human fibrinogen concentrate and thrombin were loaded into each syringe and were simultaneously injected through Y-piece and application needle (Figure 1). After a two-minute wait to allow for glue hardening, conjunctival suturing was done, as in the right eye (Figure 2a, b).

Bottom Line: The aim of this study is to determine the stabilizing effects of fibrin glue as an adjuvant to hang-back surgery.The frequency of stable insertion of the recessed muscle at the intended site was greater in the fibrin glue group (9 eyes) compared to the control group (3 eyes) (p=0.028).Fibrin glue is effective in stabilizing the new rectus muscle insertion and decreasing the displacement in the hang-back surgery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.

ABSTRACT

Background: The hang-back surgery is a useful technique in the field of strabismus surgery. The aim of this study is to determine the stabilizing effects of fibrin glue as an adjuvant to hang-back surgery.

Materials and methods: Four (4)-mm hang-back recessions of the superior rectus muscle was performed in 32 eyes of 16 rabbits. Only in the left eye of the 16 rabbits, fibrin glue was applied between the recessed muscle bed and the sclera at the end of hang-back surgery (fibrin glue group). After 6 weeks, we compared the stability of the recessed rectus muscle between the fibrin glue group and the control group by evaluating the displacement of the muscle.

Results: The frequency of stable insertion of the recessed muscle at the intended site was greater in the fibrin glue group (9 eyes) compared to the control group (3 eyes) (p=0.028). In the control group, 5 eyes showed anterior displacement and 8 eyes showed posterior displacement and in the fibrin glue group, 1 eye showed anterior displacement, and 6 eyes showed posterior displacement. Anterior displacement was more common in the control group (6.3% Vs 31.3%). The control group and the fibrin glue group showed similar histological findings on microscopic examination.

Conclusions: Fibrin glue is effective in stabilizing the new rectus muscle insertion and decreasing the displacement in the hang-back surgery.

Show MeSH
Related in: MedlinePlus