This study compared the safety and efficacy of fibrin and cyanoacrylate glue for refixating the recessed muscle to the sclera in patients undergoing strabismus surgery. The fibrin group (a) included 21 eyes of 15 patients; mean age of 11.6 ±7.49 years. The cyanoacrylate group (b) included 19 eyes of 15 patients; mean age of 12.4 ±9.98 years. Both groups were comparable for age. Each group consisted of eight males and seven females. The average time per muscle attachment was 1.48 ±0.69 minutes (group a) and 2.42 ±0.58 minutes (group b). Postoperative alignment within 10PD was achieved in every patient at six weeks. One patient developed consecutive exotropia at three months. There was no significant difference in pain between groups. Group b had significantly more chemosis with conjunctival reaction and total inflammation score. Two patients in group b developed localised granuloma formation over the site of muscle reattachment and required surgical removal of this. Both glues were equally efficacious for muscle reattachment but there were clear issues with cyanoacrylate. The authors recommend fibrin glue as a safe, effective and bio tolerant alternative to sutures and cyanoacrylate glue for recessions in strabismus surgery. 

Comparative evaluation of cyanoacrylate and fibrin glue for muscle recession in strabismus surgery.
Topiwala P, Bansal RK.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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