Efficacy of Marlex Mesh on Posterior Fixation Suture: An Experimental Study in a Rabbit Model

초록

PURPOSE: To develop a novel method of posterior fixation suture augmented by the application of Mar lex mesh and to evaluate the surgical results in a rabbit model. DESIGN: Animal study. METHODS: 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. (Am J Ophthalmol 2011;151:77-84. (C) 2011 by Elsevier Inc. All rights reserved.)

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