Tissue adhesives for a sutureless fadenoperation: an experimental study in a rabbit model.
OBJECTIVE
To use tissue adhesives for a sutureless Fadenoperation to eliminate perioperative risks related to the sutures.


METHODS
In an in vivo procedure, 120 superior recti muscles in New Zealand White rabbits were subjected to the posterior fixation procedure, at a distance of 6 mm from the insertion point of the muscle. They were divided into four groups of 30 muscles, according to the material used to perform a myopexy: group 1 (control): nonabsorbable 5-0 polyester sutures; group 2: n-butyl-2-cyanoacrylate adhesive; group 3: fibrin glue; group 4: gelatin-resorcin-formaldehyde-glutaraldehyde (GRFG) adhesive. The animals were examined at 1, 7, 14, and 21 days after surgery. Afterward, they were killed, and their eyes were enucleated to measure the distance between the myopexy and the anatomic insertion point and to assure the strength of the bond with a dynamometer. Finally, a histologic examination was performed.


RESULTS
Almost all eyes were clear after the third week, although group 4 presented the most intense inflammatory reaction. In histologic examination, groups 1 and 2 showed a chronic inflammatory reaction of the foreign-body type, with similar intensity. Fibrin glue induced minimal inflammation, but GRFG adhesive produced a pronounced reaction. Concerning the distance of the myopexy, groups 1 and 2 presented measures close to the expected distance of 6 mm, whereas groups 3 and 4 showed a greater variability. All groups performed well in the strength test, with no statistically significant differences among them.


CONCLUSIONS
n-Butyl-2-cyanoacrylate adhesive performed best in the sutureless Fadenoperation, characterized by precision in the expected distance of myopexy, sufficient resistance to separation, and acceptable inflammatory reaction.
Tonelli
Edward
E
Departamento de Oftalmologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. tonellijunior@click21.com.br
de Almeida
Henderson Celestino
HC
Bambirra
Eduardo Alves
EA
D000818:Animals; D004338:Drug Combinations; D004659:Enbucrilate / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D009877:Endophthalmitis / Q000209:etiology / Q000473:pathology; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects / Q000627:therapeutic use*; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology; D005557:Formaldehyde / Q000009:adverse effects / Q000627:therapeutic use*; D005780:Gelatin / Q000009:adverse effects / Q000627:therapeutic use*; D005976:Glutaral / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D011817:Rabbits; D012118:Resorcinols / Q000009:adverse effects / Q000627:therapeutic use*; D013285:Strabismus / Q000601:surgery*; D013537:Sutures; D013718:Tensile Strength; D014014:Tissue Adhesives / Q000627:therapeutic use*
D004338:Drug Combinations; D015718:Fibrin Tissue Adhesive; D012118:Resorcinols; D014014:Tissue Adhesives; C083703:gelatin-resorcin-formaldehyde-glutaraldehyde adhesive; D005557:Formaldehyde; D005780:Gelatin; D004659:Enbucrilate; D005976:Glutaral