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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

Histological appearance 6 weeks after the surgery. The right eye with conventional hang-back recession (A) and the left eye with fibrin glue after hang-back recession (B) showed similar findings. Rectus muscle at the insertion site was separated from the scleral surface and surrounded by fibrous tissue which was attached to the sclera. Inflammatory cells were rarely seen. Red blood cells were found more frequently in the right eye. Bar = 200 μm.
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Figure 3: Histological appearance 6 weeks after the surgery. The right eye with conventional hang-back recession (A) and the left eye with fibrin glue after hang-back recession (B) showed similar findings. Rectus muscle at the insertion site was separated from the scleral surface and surrounded by fibrous tissue which was attached to the sclera. Inflammatory cells were rarely seen. Red blood cells were found more frequently in the right eye. Bar = 200 μm.

Mentions: The control group and the fibrin glue group showed similar histological findings on microscopic examination. The sclera consisted of fine-textured collagen fibrous bundles, which were parallel to the surface of the globe. The collagen fibers in the left eye were partially cut off at the muscle insertion site, but they were nearly intact as a whole. The rectus muscle at the insertion site was separated from the scleral surface and surrounded by fibrous tissue, which was attached to the sclera. Residual fibrin glue or inflammatory cells were rarely seen (Figure 3b). The eye in the control group was not significantly different from the eye in the fibrin glue group, but it was characterized by more red blood cells (Figure 3a). The surrounding connective tissue didn’t show any significant inflammatory change.


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)

Histological appearance 6 weeks after the surgery. The right eye with conventional hang-back recession (A) and the left eye with fibrin glue after hang-back recession (B) showed similar findings. Rectus muscle at the insertion site was separated from the scleral surface and surrounded by fibrous tissue which was attached to the sclera. Inflammatory cells were rarely seen. Red blood cells were found more frequently in the right eye. Bar = 200 μm.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Histological appearance 6 weeks after the surgery. The right eye with conventional hang-back recession (A) and the left eye with fibrin glue after hang-back recession (B) showed similar findings. Rectus muscle at the insertion site was separated from the scleral surface and surrounded by fibrous tissue which was attached to the sclera. Inflammatory cells were rarely seen. Red blood cells were found more frequently in the right eye. Bar = 200 μm.
Mentions: The control group and the fibrin glue group showed similar histological findings on microscopic examination. The sclera consisted of fine-textured collagen fibrous bundles, which were parallel to the surface of the globe. The collagen fibers in the left eye were partially cut off at the muscle insertion site, but they were nearly intact as a whole. The rectus muscle at the insertion site was separated from the scleral surface and surrounded by fibrous tissue, which was attached to the sclera. Residual fibrin glue or inflammatory cells were rarely seen (Figure 3b). The eye in the control group was not significantly different from the eye in the fibrin glue group, but it was characterized by more red blood cells (Figure 3a). The surrounding connective tissue didn’t show any significant inflammatory change.

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