Reattachment of extraocular muscles using fibrin glue in a rabbit model.

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Abstract

PURPOSE: Reattaching extraocular muscles by the conventional suturing method may be complicated by scleral perforation. The attachment of extraocular muscles, using fibrin sealants, avoids such risk. The authors evaluated the use of fibrin sealant in a laboratory rabbit model. METHODS: Fifty-eight eyes of 29 rabbits were used in the study. In both eyes of each rabbit, the superior rectus muscle was disinserted, recessed, and either sutured or reattached to the globe by fibrin sealant. Two groups of eyes were compared. In one group (42 eyes), the recessed muscle was reattached using fibrin sealant. In the second group (16 eyes), sutures were used to reattach the recessed muscle to the globe. The insertion of the superior rectus muscle was examined 14 days after surgery, and histopathologic evaluation was performed 6 weeks after the surgery. RESULTS: Although in the sutured muscle group no slippage from the original placement was found, it was found in the group in which fibrin glue was used. The muscle slippage was greater at the small muscle recessions and smaller at the large muscle recessions. For muscle recession of 6 mm or more, the average muscle slippage was 0.12 +/- 0.28 mm, which was not statistically different from the suture group (P = 0.0828). CONCLUSIONS: Fibrin sealant was found to be effective for extraocular muscle reattachment only in large muscle recessions. However, in small muscle recessions the glue was not strong enough to overcome the contractive strength of the muscle.