Cut and paste: a novel method of re-attaching rectus muscles with cyanoacrylate during recessions in strabismus.
OBJECTIVE
Bio-adhesives like cyanoacrylate offer an alternative to sutures to attach tissues, including in ophthalmology. This prospective trial evaluated the suitability and bio-tolerance of iso-amyl cyanoacrylate in rectus muscle recession surgery for strabismus.


METHODS
We randomized one eye in each of 10 cases of bilateral horizontal rectus recessions to 6/0 polyglactin and the other to iso-amyl-cyanoacrylate. We compared time to reattachment (from disinsertion), complications and inflammatory scores (0 to +3: nil, mild, moderate and severe) on Day One, at two and at four to six weeks post surgery.


RESULTS
There were no significant group differences in inflammatory scores (Wilcoxon, all values of P>0.05). All attachments held firm. Gluing took significantly longer by 5.24+/-1.91 min (95% CI for difference: 3.87-6.61). There were no complications.


CONCLUSIONS
We feel that although it takes marginally longer, iso-amyl cyanoacrylate offers an effective and safe alternative to sutures for muscle recession in strabismus surgery. Since it is cheaper (vs. polyglactin) and offers multi-use possibility it may also prove to be cost-effective.
Darakshan
Anjum
A
Institute of Ophthalmology, JN Medical College, Aligarh Muslim University, Aligarh, UP, India.
Amitava
Abadan K
AK
D000293:Adolescent; D000328:Adult; D002648:Child; D003487:Cyanoacrylates / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000209:etiology; D007430:Intraoperative Care; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D011098:Polyglactin 910 / Q000627:therapeutic use; D011183:Postoperative Complications; D013285:Strabismus / Q000188:drug therapy* / Q000601:surgery*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D003487:Cyanoacrylates; D011098:Polyglactin 910