A prospective randomized pilot study comparing fibrin glue, buried suture knot and exposed suture knot techniques for conjunctival closure in bilateral symmetrical fornix approach squint surgery.
Nidhi B Agarwal, Jenil N Sheth, Hardik Nanavati et al.
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In 30 seconds
This prospective randomized pilot study compared fibrin glue (FG), buried suture knot (BSK), and exposed suture knot (ESK) for conjunctival closure in patients over 10 years old undergoing bilateral symmetric strabismus surgery through a fornix incision. Thirty eyes were randomized. FG closure was faster (37.2 ± 29.0 s) than BSK (171.6 ± 53.1 s) and ESK (148.7 ± 51.0 s) (p < .001). Symptoms were broadly similar, while FG had less inflammation at selected early assessments. The authors report comparable long-term comfort across methods.
Key findings
- Mean closure time was 37.2 ± 29.0 s with FG, versus 171.6 ± 53.1 s with BSK and 148.7 ± 51.0 s with ESK (p < .001).
- FG showed less inflammation than ESK at one week (p = .013) and BSK at two weeks (p = .015).
- Patient-reported symptoms were similar overall; FG was associated with greater comfort than BSK at two weeks (p = .030).
- At six weeks, conjunctival thickness had significantly increased from baseline in BSK and ESK eyes, but not FG eyes.
Why it matters
Conjunctival closure technique may affect operative efficiency and early postoperative tissue response after fornix-incision strabismus surgery. In this pilot comparison, fibrin glue substantially shortened closure time and showed less inflammation at selected visits, while longer-term comfort was comparable. These findings help frame the trade-off between closure efficiency and postoperative outcomes without establishing superiority across all clinically relevant measures.
What to keep in mind
This was a pilot study with only 30 randomized eyes and follow-up through six weeks, limiting the precision and duration of outcome assessment.