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Efficacy of marlex mesh on posterior fixation suture: an experimental study in a rabbit model
Hee Kyung Yang1, Sang Beom Han, Gheeyoung Choe
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Purpose:
To develop a novel method of posterior fixation suture augmented by the application of Marlex mesh and to evaluate the surgical results in a rabbit model.
Design:
Animal study.
Setting:
Prospective, masked-observer, controlled experimental study.
Study Population:
Sixty superior rectus muscles of 30 rabbits.
Intervention:
Each superior rectus muscle was randomly subjected to posterior fixation suture at a distance of 6 mm from the muscle insertion. The rabbits were divided into 3 groups: conventional posterior fixation suture (Conventional group), and modified posterior fixation suture using a silicone sponge (Silicone group) or using Marlex mesh (Marlex group). Nonabsorbable sutures were used for muscle-sclera (Conventional group) or muscle-implant fixation (Silicone and Marlex group) and absorbable sutures were used for implant-sclera fixation (Silicone and Marlex group).
Main Outcome Measures:
The efficacy of posterior fixation suture was determined by forced duction testing toward the operated-on muscle immediately after the operation and at 8 weeks postoperatively. Eyes were enucleated at 8 weeks after surgery to measure the stability of the bond using a push pull gauge, and finally the histologic findings were evaluated.
Results:
Immediately after posterior fixation suture and at 8 weeks postoperatively, the restrictive motion during duction toward the operated-on muscle was greater in the Marlex group compared to the other groups (P < .001). The resistance to separation of the myoscleral union was greatest in the Marlex group (P < .001).
Conclusions:
Posterior fixation suture can be effectively reinforced and stabilized using Marlex mesh.
