Comparative Evaluation of Cyanoacrylate and Fibrin Glue for Muscle Recession in Strabismus Surgery

Purpose: To compare the safety and efficacy of fibrin glue and cyanoacrylate glue for refixating the recessed muscle to the sclera in patients undergoing strabismus surgery. Methods: In this prospective, randomized, and interventional case series, there were 15 patients in each group. Two different types of glue were used for refixating the muscle to the sclera after its recession: fibrin glue (fibrin group) and cyanoacrylate glue (cyanoacrylate group). Resection was performed as usual with a 6-0 polyglactin suture. The conjunctiva was closed with the same glue that was used for muscle recession. Results: Average time required per muscle attachment was 1.48 ± 0.694 minutes in the fibrin group and 2.42 ± 0.584 minutes in the cyanoacrylate group. There was no significant difference in pain at all postoperative visits in both groups. Significantly more chemosis was observed in the cyanoacrylate group at postoperative 3 weeks. At all other postoperative visits, there was no significant difference in chemosis in both groups. There was significantly more conjunctival reaction in the cyanoacrylate group at 1 and 3 weeks and 3 months; the difference was highly significant at 3 months ( P = .00). Total inflammatory score was significantly high in the cyanoacrylate group at 1 week, 3 weeks, and 3 months. Conclusions: Both fibrin and cyanoacrylate glue are equally efficacious for muscle reattachment; however, fibrin glue is more biotolerant compared to cyanoacrylate glue and results in less postoperative inflammation, and is thus recommended for recession in strabismus surgery. [J Pediatr Ophthalmol Strabismus 2014;51(6):349–354.]