Christiansen S P, Rettele G A, Soulsby M E, Walls R C
Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock 72202, USA.
J Pediatr Ophthalmol Strabismus. 1996 Mar-Apr;33(2):93-7. doi: 10.3928/0191-3913-19960301-07.
The "lost" extraocular muscle is a serious adverse outcome of seemingly uncomplicated strabismus surgery. One potential cause of this complication is suture slippage in the operated muscle or tendon. The purpose of this study was to determine the relative tensile strengths of three suture techniques commonly used in strabismus surgery and to compare the incidence of suture slippage in the tendon or muscle among these techniques.
The horizontal rectus muscles of 18 adults pigs were assigned to undergo either recession or resection and were randomized to one of three suture techniques studies. Tension applied to the free ends of the suture was incrementally increased until failure occurred. The two techniques were compared in terms of the mean applied tensions at the time of failure and the incidence of slippage.
No statistically significant difference in mean tension at failure between the three techniques used in recessed or resected muscles was found. Suture slippage in the tendon or muscle occurred in 25% of the trials and was almost evenly distributed among the techniques. Mean tension at slippage did not differ significantly between the techniques. No failure of any kind occurred at less than 100 g applied tension.
Each suture technique appeared to adequately secure to tendon or muscle for recession and resection procedures. Changing techniques is unlikely to alter the incidence of lost muscles in strabismus surgery.
“丢失”的眼外肌是看似简单的斜视手术的严重不良后果。这种并发症的一个潜在原因是手术肌肉或肌腱中的缝线滑脱。本研究的目的是确定斜视手术中常用的三种缝合技术的相对拉伸强度，并比较这些技术中肌腱或肌肉缝线滑脱的发生率。
将18只成年猪的水平直肌进行后徙或缩短手术，并随机分为三种缝合技术研究之一。逐渐增加施加在缝线自由端的张力，直至发生断裂。比较这两种技术在断裂时的平均施加张力和滑脱发生率。
在后徙或缩短肌肉中使用的三种技术之间，断裂时的平均张力没有统计学上的显著差异。25%的试验中发生了肌腱或肌肉缝线滑脱，且在各技术之间分布几乎均匀。各技术之间滑脱时的平均张力没有显著差异。在施加张力小于100克时，未发生任何类型的断裂。
每种缝合技术似乎都能充分固定肌腱或肌肉以进行后徙和缩短手术。改变技术不太可能改变斜视手术中肌肉丢失的发生率。
