Institutional members access full text with Ovid®

Share this article on:

Comparison of Postoperative Eyelid Position Using Fibrin Sealant versus Suture for Wound Closure in Müller's Muscle–Conjunctiva Resection Ptosis Repair

Czyz, Craig N. D.O.; Rich, Nicole E. B.S.; Foster, Jill A. M.D.; Kavanagh, Marsha C. M.D.; Perry, Julian D. M.D.; Holck, David E. E. M.D.

Plastic and Reconstructive Surgery: August 2011 - Volume 128 - Issue 2 - p 423-430
doi: 10.1097/PRS.0b013e31821e6f73
Reconstructive: Head and Neck: Original Articles

Background: The purpose of this study was to compare postoperative eyelid position using fibrin sealant versus suture for wound closure in Müller's muscle–conjunctiva resection ptosis repair.

Methods: One hundred ninety-six patients (367 eyelids) who underwent Müller's muscle–conjunctiva resection ptosis repair were divided into two groups: wounds closed with suture and those closed with fibrin sealant. Preoperative and postoperative eyelid measurements were compared statistically using appropriate t tests. Complications, eyelid symmetry, and revision rates were analyzed using a two-tailed Fisher's exact test.

Results: Suture was used for wound closure on 53 eyelids of 39 patients and fibrin sealant was used on 314 eyelids of 157 patients. There was no statistically significant difference (p = 0.49) when comparing the change from preoperative to postoperative margin-to-reflex distance 1 between the two groups. Postoperative symmetry within 0.5 mm was achieved in 87 percent of patients in the suture group and in 96 percent of patients in the fibrin sealant group (p = 0.06). The percentage of patients requiring additional ptosis adjustment was 2 percent in both groups (p = 1.0). Major complications were more common in the suture group (p = 0.0001).

Conclusions: Müller's muscle–conjunctiva resection ptosis repair using fibrin sealant for wound closure offers equivalent lid position and symmetry as compared with suture wound closure. There is also a reduction in major postoperative complications when using fibrin sealant.

Columbus and Cleveland, Ohio; and San Antonio, Texas

From the Department of Surgery, Division of Ophthalmology, Section of Oculofacial Plastic Surgery, Ohio University/OhioHealth Doctors Hospital; Plastic Surgery Ohio/The Eye Center of Columbus; The Ohio State University School of Medicine; the Department of Ophthalmology, The Ohio State University; the Cole Eye Institute, Cleveland Clinic; and the Division of Oculofacial Plastic Surgery, Wilford Hall Medical Center.

Received for publication August 19, 2010; accepted February 25, 2011.

Presented at the Fall Meeting of the American Academy of Facial Plastic and Reconstructive Surgery, in San Diego, California, October 1 through 4, 2009.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Supplemental digital content is available for this article. A direct URL citation appears in the printed text; simply type the URL address into any Web browser to access this content. A clickable link to the material is provided in the HTML text of this article on the Journal's Web site (

Craig N. Czyz, D.O., 262 Neil Avenue, Suite 430, Columbus, Ohio 43215,

©2011American Society of Plastic Surgeons