Anterior approach ptosis surgery: comparison of absorbable polyglactin sutures and non-absorbable polyester sutures. Does Vicryl stand the test of time?
Manasseh, Gemma Hunt, Samantha Garrott, Helen Ford, Rebecca Caesar, Richard Harrad, Richard
Manasseh, Gemma
Hunt, Samantha
Garrott, Helen
Ford, Rebecca
Caesar, Richard
Harrad, Richard
Glos Author
Date
2021-08-01
Subject
Type
Journal Article
Collections
Abstract
Purpose: To determine whether the long-term success of ptosis surgery is influenced by the use of absorbable or non-absorbable sutures to advance the levator aponeurosis onto the tarsal plate.
Methods: Multi-centre retrospective comparative study of re-operation rates in primary anterior approach ptosis surgery using absorbable polyglactin sutures (Vicryl) and non-absorbable polyester sutures (Ethibond). The Medisoft audit tool was used to identify all patients who underwent primary ptosis surgery for aponeurotic ptosis, performed by five oculoplastic consultants within a 7-year period, across two NHS Ophthalmology departments. The electronic patient records were reviewed for each patient. Basic demographics, suture material, and post-operative complications were recorded. All patients requiring repeat surgery between the study dates and the present day were recorded, allowing a minimum postoperative period of 3 years and 10 months. Re-operation rates in surgery using absorbable Vicryl sutures and non-absorbable Ethibond sutures were compared using Fisher's exact test.
Results: Four hundred and fifty-five operations in 330 patients were performed within the study period that met the inclusion and exclusion criteria. Fifty-seven percent of the patients were female, with an average age of 68.8 years. One hundred and sixty-nine operations in 128 patients were performed using absorbable Vicryl sutures. Of these, 22 (13.0%) required repeat operations. Two hundred and eighty-six operations in 202 patients were performed using non-absorbable Ethibond sutures. Of these, 17 (5.9%) required repeat operations. The two-tailed P-value was 0.0143.
Conclusion: The use of non-absorbable Ethibond sutures to advance the levator aponeurosis onto the tarsal plate in primary ptosis surgery is associated with improved long-term success and reduced need for secondary surgery.
Citation
Manasseh, G. S. L., Hunt, S. V., Garrott, H., Ford, R. L., Caesar, R., & Harrad, R. A. (2022). Anterior approach ptosis surgery: comparison of absorbable polyglactin sutures and non-absorbable polyester sutures. Does Vicryl stand the test of time?. Orbit (Amsterdam, Netherlands), 41(5), 547–550. https://doi.org/10.1080/01676830.2021.1958873