가토에서 조직 접합제를 이용한 무봉합 사시 수술의 유용성

Abstract

Inadvertent perforation of the globe is the most severe complication of strabismus surgery using 6-0 vicryl. Previous studies have reported that the incidence of this complication occurs in 1% to 12.1%. In animal experiments using adhesives(Tisseel, Beriplast-P), the tissue adhesives were considered to be good materials for replacement of sutures in strabismus surgery. In clinical application, the bond strength of the immediate postoperative period is the most important factor for the success of the operation. Therefore we performed sutureless strabismus surgery with Tisseel and Beriplast-P in 10 albino rabbits to evaluate the bond strength of the immediate postoperative period. Superior and inferior rectus muscles were ercessed in 2mm length. In 5 rabbits, Tisseel was used, and those rabbits were divided into 5 groups according to the postoperative period : 10 min, 30 min, 60 min, 1 day, and 1 week after operation. The eyes were enucleated to examine the tensile strength. In the other group of 5 rabbits,Beriplast-P was used and the same experiment was performed. The mean adhesion powers in the Tisseel group were 13.13, 20.24, 22.20,51.25, and 188.76g. gravity at 10, 30, 60 min, 1 day, and 1 week,respectively. In the Beriplast-P group they were 18.28, 22.07, 36.46, 40.73, and 181.14g. gravity. The use of tissue adhesives for sutureless strabismus surgery is considered to be impractical due to inadequate bond strength of the immediate postoperative period. Tissue adhesives with strong tensile strength in the early postoperative period could be useful in strabismus surgery(J Korean Ophthalmol Soc 38:1445~1450, 1997).