Use of Polytetrafluorethylene for Delayed Adjustable Strabismus Surgery in Humans II

The author attempted to discover a method for performing delayed suture adjustment to investigate whether it actually provides more relable and stable results. In order to prevent the fromation of postoperative adhesions and delay the time of adjustment, the author used 0.1mm-thick polyteetraful-oroethylene(PTFE) as a physical barrier. PTFE was placed between the free muscle end and the sclera in 60 strabismic patients during adjustable strabismus surgery. Adjustment was not necessary in eight patients until PTFE removal. In thirteen patients, adjustment was not necessayr after first adjustment until two weeks postoperatively. PTFE was effective in delaying the adjustment after two weeks postoperatively in the remaining 39 patients. To my knowledge, this study represents the longest delayed adjustment in humans. In conclusion, PTFE can be clinically beneficial for delaying the timing of adjustment in strabismus surgery.

Use of Polytetrafluoroethylene for Delayed Adjustable Strabismus Surgery in Humans

Delayed reattachment of the muscle to the sclera may be desirable to correct the deviation of eye developed after the surgery. Based upon the results of the author` s previous experimental study on rabbits, polytetrafluoroethylene was placed around the cut end of the muscle as a physical barrier between the free muscle end and the sclera in seven strabismus patients in order to prevent the postoperative adhesions. Polytetrafluoroethylene (PTFE) was effective in delaying the adjustment more than 2 weeks after surgery in 4 out of 7 patients. In 3 remaining patients, adjustment was not necessary in 2 patients up to 22 days postoperatively because of the desirable postoperative state and suture was lost in a 65-year-old patient. In every case, PTFE was removed after final adjustment. In conclusion, PTFE may be clinically useful for delaying the timing of adjustment.

The Effect of Polytetrafluoroethylene on Delayed Adjustable Strabismus Surgery

Delayed reattachment of the muscle to the sclera may be desirable to correct the deviation of eye developed after the surgery. Polytetrafluoroethylene(PTFE) was placed around the cut end of the muscle as a physical barrier between the free muscle end and the sclera in 16 rabbits in order to prevent the postoperative adhesions. PTFE was effective in delaying the adjustment for up to 4 weeks after surgery in 4 out of 10 eyes. After removal of PTFE, adjustment was possible up to 12 weeks in 24 out of 25 eyes because there was no adhesion between the muscle and PTFE. In conclusion, PTFE may be clinically helpful for delaying the timing of adjustment.

The Effect of Physical Barriers on Delayed Adjustable Strabismus Surgery

Delayed reattachment of the muscle to the sclera may be desirable to correct the angle of deviation developed after the surgery of strabismus. In order to know the possible time for the delayed adjustment, the authors tried Viscoat(R). Interceed(TC7) and polyglactin 910 mesh(Vicryl mesh(R)) as physical barriers for preventing the formation of postoperative adhesions. These materials were placed around between the detached end of the muscle and the sclera in 29 rabbits and adjustment was performed thereafter. Viscoat(R) was effective in delaying the adjustment up to 6 days after surgery. Interceed(TC7) and polyglactin 910 mesh were effective in delaying the adjustment up to 1 week after surgery.

Effects of 5-Fluorouracil on Delayed Adjustment in Experimental Strabismus Surgery

Adjustable sutures increased the rate of success with a single procedure, but sometimes fails because of changes in the angle of deviation which develops a few days after surgery. Therefore, the delayed adjustment was attempted;however, the postoperative adhesion following strabismus surgery make delayed adjustment impossible. We studied 45 eyes of 25 rabbits; adjustable strabismus surgery underwent a hang-back technique in the superior rectus muscle. In experimental group, a sponge was soaked in 5-Fluorouracil, and the sponge was placed between the conjunctiva and the sclera for 5 minutes during the operation. We studied the possible time of delayed adjustment and estimated the minimal forces required for the adjustment. The experimental group A (5-Fluorouracil, 50mg/ml) allowed for a 6 day delayed adjustment after surgery, control group allowed for a 2 day delayed adjustment after surgery. These results suggest that 5-Fluorouracil may valuable resource to delayed adjustment strabismus surgery by reduce postoperative adhesion.

Effects of mitomycin C on delayed adjustment in experimental strabismus surgery

In adjustable strabismus surgery, a satisfactory final result would be achieved with delayed adjustment. However, the postoperative adhesions following strabismus surgery make delayed adjustment impossible. We evaluated the efficacy of mitomycin C in reducing the severity of postoperative adhesions following strabismus surgery and in delaying the time adjustment after surgery. Experimental rabbits underwent a hang-back recession procedure in the superior rectus muscle. A topical application of mitomycin C was made between the conjunctiva and the sclera for 5 minutes during the operation. We then studied the possible time of delayed adjustment and estimated the minimal forces required for the adjustment. The topical application of 0.1 mg/ml mitomycin C between the conjunctiva and sclera allowed for a 2-week delayed adjustment after surgery, and 0.2 mg/ml mitomycin C prevented the adhesions between these tissues and the muscle 5 weeks after surgery. These results suggest that topical mitomycin C may enhance the success rate of strabismus surgery with delayed adjustment and reduce postoperative adhesions.