Efficacy of Polytetrafluoroethylene/Polylactide-co-glycolide (PTFE/PLGA) Laminate and PTFE/PLGA Laminate Containing Slow-Releasing Thalidomide in Delayed Adjustable Strabismus Surgery in a Rabbit Model

Purpose: To evaluate the efficacy of polytetrafluoroethylene/polylactide-co-glycolide (PTFE/PLGA) laminate containing sustained-release thalidomide for delayed adjustable strabismus surgery. Methods: This is a prospective, masked-observer, controlled study using 50 eyes of 25 rabbits. After superior rectus muscle (SRM) recession, a PTFE/PLGA laminate containing thalidomide (group PT, 20 eyes), PTFE/PLGA laminate alone (group P, 20 eyes), or no barrier (group C, 10 eyes) were applied around the SRM. Delayed adjustment was performed at postoperative 3 or 5 weeks. Adjustability, adjustment lengths, adjustment forces, and degrees of adhesion were evaluated. Results: Both groups PT and P showed significantly better adjustability compared to group C at both 3 weeks (100%, 80%, and 0%, respectively) and 5 weeks (100%, 90%, and 0%, respectively). Between groups PT and P, adjustability, adjustment lengths, and forces were not significantly different at 3 and 5 weeks. Group PT showed a significantly lower grade of adhesion between SRM and sclera (SRM/S) compared to group C at both 3 weeks (p = 0.007) and 5 weeks (p = 0.001, respectively). Group P showed no significant difference in adhesion between SRM/S compared to group C at 3 weeks (p= 0.302) but had a lower grade of adhesion after 5 weeks (p = 0.007). There was no significant difference between groups PT and P at 3 weeks (p= 0.143) and 5 weeks (p= 0.716). Conclusions: PTFE/PLGA laminate containing sustained-release thalidomide was effective in reducing adhesion and allowed delayed adjustment in all eyes. However, PTFE/PLGA laminate alone was also equally effective in reducing adhesion compared to controls.