Use of Physical Barriers for the Surgical Treatment of Fat Adherence Syndrome: The Effect of Viscoat, Interceed, Polyglactin 910 Mesh and Polytetrafluoroethylene

ABSTRACT

The fat adherence syndrome is a type of restrictive strabismus resulting from the formation of adherence of orbital tissues to the globe or extraocular muscles in association with violation of Tenon`s capsule. The treatment of fat adherence syndrome has been extremely difficult. In order to determine the efficacy to prevent the development of restrictive scar tissue, the authors created adhesion of inferior rectus muscle to inferior orbital rim in 40 eyes of 20 rabbits. This was followed by placement of normal saline in control group, and Viscoat, Interceed(TC7), polyglactin 910 mesh and polytetrafluoroethylene(PTFE) in experimental groups as physical barriers between the inferior rectus muscle and hole of Tenon`s capsule. Forced ductions were performed 4 weeks postoperatively and histologic examinations were performed. Viscoat made less adhesion, although no difference was noted in terms of length and force for duction. Polyglactin 910 mesh failed to make less adhesion and any difference in length and force for duction. Interceed caused less force for duction, but no difference in the degree of adhesion and the length for duction. Polytetrafluoroethylene(PTFE) did prevent the formation of adhesion between the body of PTFE and the muscle, however the fibrous membrane formed at the edge of PTFE prevented the eye movement. Thus there was no difference in terms of length and force for duction as well as the degree of adhesion in PTFE group. In conclusion, these results may be helpful for studying the management of fat adherence syndrome.