Strabismus · 2026
A prospective randomized pilot study comparing fibrin glue, buried suture knot and exposed suture knot techniques for conjunctival closure in bilateral symmetrical fornix approach squint surgery.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Agarwal Nidhi B, Sheth Jenil N, Nanavati Hardik, Sharma Supriya S, Naik Mekhla, Gupta Ritik
Аннотация
PURPOSE: This study compared fibrin glue (FG), buried suture knot (BSK), and exposed suture knot (ESK) for conjunctival closure in bilateral symmetrical squint surgery through fornix incision.
METHOD: This study enrolled patients over 10-years age undergoing bilateral, symmetric strabismus surgery. Pre-operative anterior segment optical coherence tomography (ASOCT) and slit-lamp photography were performed on the pre-determined surgical quadrant. All the patients underwent strabismus surgery using a fornix incision. Eyes were randomized using a block design to one of the 3 conjunctival closure groups. Conjunctival closure time was recorded. Post-operative assessments were conducted at 1 day, 1 week, 2 weeks, and 6 weeks. These assessments included: patient-reported pain, foreign body sensation (FB), itching, watering. Clinical signs of conjunctival hyperemia, discharge, and chemosis were assessed using a standardized scale. ASOCT and slit-lamp photography of the surgical site were done at each post-operative visit. Conjunctival thickness was measured from ASOCT images. Statistical analysis was performed by SPSS 23.0 version. Variables with p value < 0.05 were considered as statistically significant.
RESULTS: A total of 30 eyes were randomized to FG, BSK, or ESK group. The FG group demonstrated significantly faster conjunctival closure time (37.2 ± 29.0 s) compared to BSK (171.6 ± 53.1 s) and ESK (148.7 ± 51.0 s) (p < .001). Patient-reported symptoms were similar across groups; however, FG showed significantly greater comfort than BSK at two-weeks (p = .030). Objectively, FG exhibited significantly less inflammation than ESK at one-week (p = .013) and BSK at two-weeks (p = .015). Both BSK and ESK eyes and not FG eyes showed a significant increase in conjunctival thickness at six-weeks when compared to their pre-operative thickness. The BSK group developed a significantly thicker conjunctiva at two-weeks compared to both FG (p = .033) and ESK (p = .022). Complications in the FG group included one eye each with wound gaping and bacterial surgical site infection, while the ESK group had one eye with Tenon-cyst.
CONCLUSION: Long-term patient comfort was comparable across all closure methods following fornix incision strabismus surgery. FG significantly reduced surgical time and early objective inflammation, offering an efficiency advantage. Both BSK and ESK techniques showed no significant difference in postoperative outcome or long-term comfort.
METHOD: This study enrolled patients over 10-years age undergoing bilateral, symmetric strabismus surgery. Pre-operative anterior segment optical coherence tomography (ASOCT) and slit-lamp photography were performed on the pre-determined surgical quadrant. All the patients underwent strabismus surgery using a fornix incision. Eyes were randomized using a block design to one of the 3 conjunctival closure groups. Conjunctival closure time was recorded. Post-operative assessments were conducted at 1 day, 1 week, 2 weeks, and 6 weeks. These assessments included: patient-reported pain, foreign body sensation (FB), itching, watering. Clinical signs of conjunctival hyperemia, discharge, and chemosis were assessed using a standardized scale. ASOCT and slit-lamp photography of the surgical site were done at each post-operative visit. Conjunctival thickness was measured from ASOCT images. Statistical analysis was performed by SPSS 23.0 version. Variables with p value < 0.05 were considered as statistically significant.
RESULTS: A total of 30 eyes were randomized to FG, BSK, or ESK group. The FG group demonstrated significantly faster conjunctival closure time (37.2 ± 29.0 s) compared to BSK (171.6 ± 53.1 s) and ESK (148.7 ± 51.0 s) (p < .001). Patient-reported symptoms were similar across groups; however, FG showed significantly greater comfort than BSK at two-weeks (p = .030). Objectively, FG exhibited significantly less inflammation than ESK at one-week (p = .013) and BSK at two-weeks (p = .015). Both BSK and ESK eyes and not FG eyes showed a significant increase in conjunctival thickness at six-weeks when compared to their pre-operative thickness. The BSK group developed a significantly thicker conjunctiva at two-weeks compared to both FG (p = .033) and ESK (p = .022). Complications in the FG group included one eye each with wound gaping and bacterial surgical site infection, while the ESK group had one eye with Tenon-cyst.
CONCLUSION: Long-term patient comfort was comparable across all closure methods following fornix incision strabismus surgery. FG significantly reduced surgical time and early objective inflammation, offering an efficiency advantage. Both BSK and ESK techniques showed no significant difference in postoperative outcome or long-term comfort.