Efficacy of posterior fixation suture augmented with talc or doxycycline

Abstract

To compare the efficacy of posterior fixation using talc or doxycycline with the conventional posterior fixation suture. Thirty superior rectus muscles in 15 rabbits were divided into three groups. Each superior rectus muscle underwent one of three different procedures: conventional posterior fixation suture with non-absorbable suture (conventional group), posterior fixation with absorbable suture and application of talc (talc group), or posterior fixation suture with absorbable suture and application of doxycycline (doxycycline group). Eight weeks postoperatively, adhesion formation, tensile strength, and histologic findings were evaluated in a masked fashion. Myoscleral adhesion formation was localized to the suture passage in the conventional and doxycycline groups. In the talc group, a wide and continuous myoscleral adhesion was formed between the two sutures. The average tensile strength of myoscleral union did not show significant difference between the talc group (353 +/- 70 gram weight) and conventional group (309 +/- 61 gram weight) (p = 0.234). In the the doxycycline group, it was significantly weaker than conventional group (p = 0.000). There were no abnormal histologic findings, except for fibrosis in the muscle and the sclera. Modified posterior fixation suture technique using absorbable suture and talc has the potential to reinforce myoscleral union.