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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A synthetic, absorbable suture (Vicryl), was investigated for its usability in eye-muscle surgery. In experimental investigations on animals and strabismus surgery in humans, properties of the suture were compared with those of plain catgut. Histological investigations after modified strabismus surgery on rabbits clearly showed a smaller degree of tissue reaction around the hydrolytically dissolvable synthetic suture than around plain catgut. After implantation of Vicryl or catgut into the anterior chamber of rabbit eyes, within the first eight days both cause infective reactions which were somewhat stronger with Vicryl, which caused more scarring over the iris, than with catgut. One-hundred and eighty strabismus operations on man showed that the synthetic suture handles better and rips less markedly than plain catgut, whereas duration and amount of postoperative irritations are similar. Overreactions and granuloma were rare.
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PMID:[Synthetic, absorbable suture in eye-muscle surgery (author's transl)]. 34 38

The new absorbable synthetic sutures, polyglycolic and (Dexon) and Polyglactin 910 (Vicryl), are excellent sutures for strabismus surgery, but they have a bothersome tendency to attract adjacent tissue (tissue-drag). This difficulty is found especially with the 5-0 size suture, less so with the 6-0 size suture, and minimally with the 7-0 size suture. The presence and number of short, stubbly, protuberant strands (hooklets) seen on the surface of these sutures under high magnification correlates with the lack of ease with which the sutures pass through tissue. Other factors involved in tissue-drag include the crevices between braids in these sutures and the fiber-tissue friction due to the innate nature of the suture materials. Sutures which pass with ease through tissue, such as catgut and nonabsorbable sutures, are seen to have smooth surfaces under high magnification. Coating the 5-0 and 6-0 Dexon and Vicryl sutures to smooth their surfaces and reduce tissue-drag was ineffective with isotonic saline solution, minimally to moderately effective with glycerine and with methylcellulose and polyvinyl alcohol solutions, but highly effective with peanut and sesame oils. Though tissue-passage of Dexon and Vicryl sutures was much improved by coating with oil and entirely satisfactory, it still was not quite as good as with catgut. Clinically, the oil did not compromise the knot security or ease of handling of the sutures. No unusual postoperative reaction was seen with the use of the oiled sutures. Although oiling the synthetic absorbable sutures at time of surgery is effective, we recommend that suture manufacturers reduce the tissue-drag of synthetic absorbable sutures either by smoothing the surface in the manufacturing process or by developing an absorbable coating applied to the sutures during manufacture.
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PMID:"Tissue-drag" with polyglycolic acid (Dexon) and polyglactin 910 (Vicryl) sutures in strabismus surgery. 101 25

An experimental animal study was conducted to determine whether fibrin glue could be used in strabismus surgery (recession, resection, and muscular neurotization). Fibrin glue was used in place of some or all of the commonly used 7-0 Vicryl sutures. In order to evaluate the adhesion of the fibrin glue the rabbits' eyes were enucleated 10-67 days after surgery, fixed in 8% formalin solution and then histologically examined. In the recession and resection specimens a solid joint between muscles and sclera was found, without any significant scar formation or atrophy of the muscles. The muscular neurotization specimens also exhibited a firm connection between the two muscles, with no abnormal loss of muscle fibers by cicatrization or atrophy. In none of the cases did the conjunctiva show any tendency to conglutination. In view of the simplicity of the fibrin gluing technique and the uniform bonding effect, application in human patients is recommended.
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PMID:[Fibrin gluing of the extraocular eye muscles. Experimental use in the rabbit]. 246 1

Iatrogenic damage to the orbital fascial system during strabismus surgery may lead to adherences with resulting problems of motility. To prevent new adherences in revisional surgery, several materials were tried, with varying degrees of success. The authors tested Polyglactin 910, popular as a suture material in strabismus surgery, in the form of a net. The material is hydrolytically soluble. Since the tissue response is finished before dissolution of the implant, it seemed that Polyglactin would be a suitable barrier to the formation of adhesions in Tenon's capsule. The implant was applied in 11 patients, some of whom had already undergone several strabismus operations and had adhesions at the surgical site. In one case the implant was used in a primary procedure. In one patient revisional surgery was needed four weeks after surgery because of overeffect, and this provided an opportunity to investigate the implanted area histologically.
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PMID:[Polyglactin 910 implants in muscle revision surgery for the reconstruction of physiologic limits in Tenon's capsule]. 323 30

Knot integrity of a new coated polyglycolic acid suture (Dexon Plus) was compared to that using uncoated polyglycolic acid (Dexon-S) and coated polyglactin-910 (Vicryl) for extraocular muscle recessions in rabbits. Knot integrity was found to be virtually identical using 6-0 sutures of any of these materials. Top throws of 5-0 coated Dexon or 5-0 coated Vicryl had a tendency to loosen in a few cases, though this was eliminated in later operations by more careful tightening of knots and avoidance of cutting suture ends to a length less than 2 mm. Subjectively observed differences in "tissue drag" were insignificant in this model.
J Pediatr Ophthalmol Strabismus
PMID:Knot integrity of coated synthetic absorbable sutures used for extraocular muscle surgery in a rabbit model. 627 14

Six patients undergoing bilateral symmetric strabismus surgery were enrolled in this study. For each subject, incisions were closed with Vicryl in one eye and glue in the other. The conjunctival closure with the Vicryl suture resulted in increased discomfort and inflammation during the early postoperative period compared with fibrin glue. However, the difference between the Vicryl and the glue disappeared after 14 days.
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PMID:Conjunctival closure in strabismus surgery: Vicryl versus fibrin glue. 893 9