title: Comparison of postoperative eyelid position using fibrin sealant versus suture for wound closure in Müller's muscle-conjunctiva resection ptosis repair.
abstract: BACKGROUND
  The purpose of this study was to compare postoperative eyelid position using fibrin sealant versus suture for wound closure in Müller's muscle-conjunctiva resection ptosis repair.
  
  
  METHODS
  One hundred ninety-six patients (367 eyelids) who underwent Müller's muscle-conjunctiva resection ptosis repair were divided into two groups: wounds closed with suture and those closed with fibrin sealant. Preoperative and postoperative eyelid measurements were compared statistically using appropriate t tests. Complications, eyelid symmetry, and revision rates were analyzed using a two-tailed Fisher's exact test.
  
  
  RESULTS
  Suture was used for wound closure on 53 eyelids of 39 patients and fibrin sealant was used on 314 eyelids of 157 patients. There was no statistically significant difference (p = 0.49) when comparing the change from preoperative to postoperative margin-to-reflex distance 1 between the two groups. Postoperative symmetry within 0.5 mm was achieved in 87 percent of patients in the suture group and in 96 percent of patients in the fibrin sealant group (p = 0.06). The percentage of patients requiring additional ptosis adjustment was 2 percent in both groups (p = 1.0). Major complications were more common in the suture group (p = 0.0001).
  
  
  CONCLUSIONS
  Müller's muscle-conjunctiva resection ptosis repair using fibrin sealant for wound closure offers equivalent lid position and symmetry as compared with suture wound closure. There is also a reduction in major postoperative complications when using fibrin sealant.
authors.affiliation: Columbus and Cleveland, Ohio; and San Antonio, Texas From the Department of Surgery, Division of Ophthalmology, Section of Oculofacial Plastic Surgery, Ohio University/OhioHealth Doctors Hospital; Plastic Surgery Ohio/The Eye Center of Columbus; The Ohio State University School of Medicine; the Department of Ophthalmology, The Ohio State University; the Cole Eye Institute, Cleveland Clinic; and the Division of Oculofacial Plastic Surgery, Wilford Hall Medical Center.
authors.forename: Craig N
authors.initials: CN
authors.lastname: Czyz
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Rich
authors.forename: Jill A
authors.initials: JA
authors.lastname: Foster
authors.forename: Marsha C
authors.initials: MC
authors.lastname: Kavanagh
authors.forename: Julian D
authors.initials: JD
authors.lastname: Perry
authors.forename: David E E
authors.initials: DEE
authors.lastname: Holck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000503:physiopathology / Q000601:surgery*; D003228:Conjunctiva / Q000601:surgery*; D005143:Eyelids / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives