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Fibrin sealant for Müller muscle-conjunctiva resection ptosis repair
Jill A Foster1, David E E Holck, Julian D Perry
1The Ohio State University, Columbus, USA.
Purpose:
To determine the safety and efficacy of fibrin sealant for use in Müller muscle-conjunctiva resection ptosis repair.
Methods:
This was a retrospective review of a consecutive case series. All patients underwent Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure. Surgery was performed in a manner similar to a previously described technique, using fibrin tissue sealant rather that suture for wound closure. Postoperative symmetry was defined as MRD1 of each eyelid within 0.5 mm.
Results:
Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure was performed on 53 eyelids of 33 patients. There were 27 female patients and 6 male patients. Twenty patients underwent bilateral ptosis repair and 13 patients underwent unilateral ptosis repair. Average follow-up was 17 weeks (range, 3 to 45 weeks). Mean preoperative MRD1 was 1.22 mm (range, -1.5 to 2.5 mm) in the right upper eyelid and 1.50 mm (range, 0 to 2 mm) in the left upper eyelid. Mean postoperative MRD1 was 3.11 mm (range, 2 to 4.5 mm) in the right upper eyelid and 3.12 mm (range, 1 to 4.5 mm) in the left upper eyelid. Postoperative symmetry was found in 32 of 33 patients (97%). We found no evidence of keratopathy or other complications attributable to the fibrin sealant.
Conclusions:
Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure may allow for predictable results with few complications and appears to be an acceptable alternative to traditional suture techniques.
Insights
Fibrin sealant offers a safe and effective alternative for wound closure in Müller muscle-conjunctiva resection ptosis repair. This method achieved high eyelid symmetry with minimal complications, making it a viable option compared to sutures.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Ptosis repair often involves Müller muscle-conjunctiva resection.
- Traditional suture techniques for wound closure can be time-consuming and may lead to complications.
Purpose of the Study:
- To evaluate the safety and efficacy of using fibrin sealant for wound closure in Müller muscle-conjunctiva resection ptosis repair.
Main Methods:
- A retrospective review of 53 eyelids in 33 patients undergoing ptosis repair.
- Fibrin sealant was used for wound closure instead of sutures.
- Postoperative symmetry was assessed by measuring margin-to-reflex distance (MRD1).
Main Results:
- High postoperative eyelid symmetry (97%) was achieved, with MRD1 within 0.5 mm in 32 of 33 patients.
- No significant complications, such as keratopathy, were attributed to the fibrin sealant.
- Mean preoperative MRD1 improved significantly post-surgery.
Conclusions:
- Fibrin sealant is a safe and effective alternative for wound closure in this ptosis repair technique.
- The use of fibrin sealant allows for predictable outcomes and appears to be a suitable substitute for sutures.
