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Conjunctival suture internal or external knotting in strabismus surgery: effect on healing and comfort

Year 2022, Volume: 8 Issue: 3, 354 - 358, 04.05.2022
https://doi.org/10.18621/eurj.931408

Abstract

Objectives: To evaluate the effectiveness of the conjunctival suture tied internally and externally on patient comfort and suture dissolution in the postoperative period in patients who underwent symmetrical strabismus surgery.


Methods:
In 50 patients who underwent surgery in the Beyoğlu Eye Training and Research Hospital Strabismus Unit, the conjunctiva was closed by tying the conjunctival suture externally in the right eye and internally tying the left eye. Absorbable 8/0 polyglactin suture was used for conjunctival suturing in all patients. Pain, itching, tearing and, discomfort sensations of the patients were questioned and a slit-lamp examination for conjunctival inflammation and dissolution of the suture were evaluated on the postoperative 1st day, 1st week, 1st month, and 6th weeks.

Results: Twenty-two patients were female and 28 were male. The mean age of the patients was 7.24 ± 4.83 (range: 4-17) years. When the pain, stinging and discomfort of the patients were questioned, 46% of the patients stated that they felt more comfortable in the left eye on the 1st and 10th days, while 48% of the patients stated that they were equal in both eyes. When we evaluated the melting of the suture and conjunctival redness, it was observed that the suture in the left eye was melted prematurely at a rate of 40% and, the conjunctival redness resolved early in the first month. There were equal pain and redness in both eyes at a rate of 54%.


Conclusions:
In strabismus surgery, the closure of the conjunctiva by tying the suture internally is thought to increase patient comfort in the postoperative period.

References

  • 1. Coats DK, Olitsky SE. Strabismus surgery and its complications. Berlin: Springer-Verlag; 2007: p.190.
  • 2. Arana LA, Ramos Moreira AT, Grandinetti AA, Moreira H, Moreria Jr CA. Novel vicryl releasable suture technique to close leaking sclerotomies in a transconjunctival vitrectomy. Retina 2019;39 Suppl 1:S108-11. 
  • 3. Apt L, Voo I, Isenberg SJ. A randomized clinical trial of the nonsteroidal eyedrop diclofenac after strabismus surgery. Ophthalmology 1998;105:1448-52.
  • 4. Kim TS, Kang NY. Effect of topical nonsteroidal anti-inflammatory drugs versus topical steroids after strabismus surgery. J Korean Ophthalmol Soc 2003;44:115-20.
  • 5. Lee JH, Kang NY. Comparison of fibrin glue and sutures for conjunctival wound closure in strabismus surgery. Korean J Ophthalmol 2011;25:178-84.
  • 6. Alio JL, Gomez J, Mulet E, Bujanda MMM, Martinez JMM, Molina Y. A new acrylic tissue adhesive for conjunctival surgery: experimental study. Ophthalmic Res 2003;35:306-12.
  • 7. Ryu WY, Yoo KW. Comparison of 2-octylcyanoacrylate and suture with 8-0 polyglactin for conjunctival wound closure in rabbits. J Korean Ophthalmol Soc 2005;46:896-903.
  • 8. Erbağcı İ, Bekir N. Sutureless closure of the conjunctiva with a commercial fibrin sealant in extraocular muscle surgery for strabismus. Strabismus 2007;15:89-94.
  • 9. Basmak H, Gursoy H, Cakmak AI, Niyaz L, Yildirim N, Sahin A. Tissue adhesives as an alternative for conjunctival closure in strabismus surgeries. Strabismus 2011;19:59-62.
  • 10. Biender B, Rosenthal G. Conjunctival closure in strabismus surgery: vicryl versus fibrin glue. Ophthalmic Surg Lasers 1996; 27:976.
  • 11. Dadeya S, Kamlesh MS. Strabismus surgery: fibrin glue versus vicryl for conjunctival closure. Acta Ophthalmol Scand 2001;79:515-7.
  • 12. Yang MB, Melia M, Lambert SR, Chiang MF, Simpson JL, Buffenn AN. Fibrin glue for closure of conjunctival incision in strabismus surgery. A report by the American Academy of Ophthalmology. Ophthalmology 2013;120:1935-41.
  • 13. Graham SL, Murray B, Goldberg I. Closure of fornix based post-trabeculectomy conjunctival wound leaks with autologous fibrin glue. Am J Ophthalmol 1992;114: 221-2.
  • 14. Spierer A, Barequet I, Rosner M, Solomon AS, Matinowitz U. Reattachment of extra-ocular muscles using fibrin glue in a rabbit model. Invest Ophthalmol Vis Sci 1997;38:543-6.
  • 15. Zarbin M. Declining use of sutures for wound closure. Arch Ophthalmol 2012;130:1596.
  • 16. Chaurasia SS, Champakalakshmi R, Angunawela RI, Tan DT, Mehta JS. Optimization of fibrin glue spray systems for ophthalmic surgery. Transl Vis Sci Technol 2012;1:2.
  • 17. Escardo´-Paton JA, Harrad RA. Duration of conjunctival redness following adult strabismus surgery. J AAPOS 2009;13:583-6.
Year 2022, Volume: 8 Issue: 3, 354 - 358, 04.05.2022
https://doi.org/10.18621/eurj.931408

Abstract

References

  • 1. Coats DK, Olitsky SE. Strabismus surgery and its complications. Berlin: Springer-Verlag; 2007: p.190.
  • 2. Arana LA, Ramos Moreira AT, Grandinetti AA, Moreira H, Moreria Jr CA. Novel vicryl releasable suture technique to close leaking sclerotomies in a transconjunctival vitrectomy. Retina 2019;39 Suppl 1:S108-11. 
  • 3. Apt L, Voo I, Isenberg SJ. A randomized clinical trial of the nonsteroidal eyedrop diclofenac after strabismus surgery. Ophthalmology 1998;105:1448-52.
  • 4. Kim TS, Kang NY. Effect of topical nonsteroidal anti-inflammatory drugs versus topical steroids after strabismus surgery. J Korean Ophthalmol Soc 2003;44:115-20.
  • 5. Lee JH, Kang NY. Comparison of fibrin glue and sutures for conjunctival wound closure in strabismus surgery. Korean J Ophthalmol 2011;25:178-84.
  • 6. Alio JL, Gomez J, Mulet E, Bujanda MMM, Martinez JMM, Molina Y. A new acrylic tissue adhesive for conjunctival surgery: experimental study. Ophthalmic Res 2003;35:306-12.
  • 7. Ryu WY, Yoo KW. Comparison of 2-octylcyanoacrylate and suture with 8-0 polyglactin for conjunctival wound closure in rabbits. J Korean Ophthalmol Soc 2005;46:896-903.
  • 8. Erbağcı İ, Bekir N. Sutureless closure of the conjunctiva with a commercial fibrin sealant in extraocular muscle surgery for strabismus. Strabismus 2007;15:89-94.
  • 9. Basmak H, Gursoy H, Cakmak AI, Niyaz L, Yildirim N, Sahin A. Tissue adhesives as an alternative for conjunctival closure in strabismus surgeries. Strabismus 2011;19:59-62.
  • 10. Biender B, Rosenthal G. Conjunctival closure in strabismus surgery: vicryl versus fibrin glue. Ophthalmic Surg Lasers 1996; 27:976.
  • 11. Dadeya S, Kamlesh MS. Strabismus surgery: fibrin glue versus vicryl for conjunctival closure. Acta Ophthalmol Scand 2001;79:515-7.
  • 12. Yang MB, Melia M, Lambert SR, Chiang MF, Simpson JL, Buffenn AN. Fibrin glue for closure of conjunctival incision in strabismus surgery. A report by the American Academy of Ophthalmology. Ophthalmology 2013;120:1935-41.
  • 13. Graham SL, Murray B, Goldberg I. Closure of fornix based post-trabeculectomy conjunctival wound leaks with autologous fibrin glue. Am J Ophthalmol 1992;114: 221-2.
  • 14. Spierer A, Barequet I, Rosner M, Solomon AS, Matinowitz U. Reattachment of extra-ocular muscles using fibrin glue in a rabbit model. Invest Ophthalmol Vis Sci 1997;38:543-6.
  • 15. Zarbin M. Declining use of sutures for wound closure. Arch Ophthalmol 2012;130:1596.
  • 16. Chaurasia SS, Champakalakshmi R, Angunawela RI, Tan DT, Mehta JS. Optimization of fibrin glue spray systems for ophthalmic surgery. Transl Vis Sci Technol 2012;1:2.
  • 17. Escardo´-Paton JA, Harrad RA. Duration of conjunctival redness following adult strabismus surgery. J AAPOS 2009;13:583-6.
There are 17 citations in total.

Details

Primary Language English
Subjects Ophthalmology
Journal Section Original Articles
Authors

Ceren Gürez 0000-0001-9519-8715

Zahid Hüseyinhan 0000-0003-1798-2912

Birsen Gökyiğit 0000-0002-4154-4106

Publication Date May 4, 2022
Submission Date May 11, 2021
Acceptance Date April 4, 2022
Published in Issue Year 2022 Volume: 8 Issue: 3

Cite

AMA Gürez C, Hüseyinhan Z, Gökyiğit B. Conjunctival suture internal or external knotting in strabismus surgery: effect on healing and comfort. Eur Res J. May 2022;8(3):354-358. doi:10.18621/eurj.931408

e-ISSN: 2149-3189 


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