Korean J Ophthalmol.  2011 Jun;25(3):178-184. 10.3341/kjo.2011.25.3.178.

Comparison of Fibrin Glue and Sutures for Conjunctival Wound Closure in Strabismus Surgery

• Lee JH
• Kang NY

• KMID: 1010025
• DOI: http://doi.org/10.3341/kjo.2011.25.3.178

Abstract

PURPOSE
To evaluate and compare the efficacy and tolerance of fibrin glue and sutures for closing conjunctival wounds in strabismus surgery.
METHODS
In a prospective trial, we performed strabismus surgery using limbal incisions. Conjunctival wounds were closed with fibrin glue in 20 eyes of 20 patients (fibrin group) and 8-0 polyglactin suture in 20 eyes of 20 patients (suture group). Postoperative pain, tearing, and inflammation were compared at 1 day, 1 week, 3 weeks, and 6 weeks after surgery. Conjunctival incision healing was also investigated.
RESULTS
One day and one week post-operatively, pain and tearing scores were lower in the fibrin group (p = 0.000, respectively). Mean surgery time was significantly shorter in the fibrin (48 +/- 5 minutes) than the suture group (63 +/- 7 minutes) (p = 0.000). Inflammation was significantly more severe in the suture group until 3 weeks postoperative (p = 0.000, respectively), but conjunctival healing did not differ between the groups. Hyperemia appeared more prominent in the fibrin group 3 and 6 weeks after surgery (p = 0.087 and 0.000, respectively). Two eyes in the fibrin group showed conjunctival gaps of more than 2 mm, which closed spontaneously by three weeks after surgery. No allergic reactions or infections developed.
CONCLUSIONS
Fibrin glue proved to be as effective as sutures in closing conjunctival wounds. It provides more comfortable early postoperative courses and might be considered as an alternative to sutures in strabismus surgery.

Keyword

Conjunctival wound closure; Fibrin tissue adhesive; Polyglactin suture; Strabismus surgery

MeSH Terms

Adolescent
Adult
Child
Child, Preschool
Conjunctiva/*surgery
Fibrin Tissue Adhesive/*therapeutic use
Humans
Inflammation/etiology/pathology
Male
Middle Aged
Pain, Postoperative/etiology/physiopathology
Polyglactin 910
Postoperative Period
Severity of Illness Index
Strabismus/*surgery
*Sutures/adverse effects
Tears/secretion
Tissue Adhesives/*therapeutic use
*Wound Closure Techniques/adverse effects
Young Adult

Figure

• 

  Fig. 1 (A) Commercial fibrin glue (Greenplast®). (B) Application of Greenplast® on scleral corners along the free edges of the conjunctival flap. (C) Using two forceps, opposing edges of the conjunctiva are pressed and attached to each other. (D) Conjunctival wound closed using fibrin.

• 

  Fig. 2 Mean postoperative pain scores at four follow-up time points. *p = 0.000.

• 

  Fig. 3 Mean postoperative tearing scores at four follow-up time points. *p = 0.000.

• 

  Fig. 4 Mean postoperative inflammatory scores at four follow-up time points. *p = 0.000.

• 

  Fig. 5 Mean postoperative conjunctival gap sizes at four follow-up time points. No significant differences were noted between the groups (p = 0.019, 0.240, 0.240, and 1.00 at each time point).

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  Fig. 6 Photographs of conjunctival healing in the fibrin (A-C) and suture groups (D-F) at postoperative time points. Arrows indicate conjunctival incision lines.

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