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OBJECTIVES: For nerve injuries, not amendable to tensionless epineural coaptation of the nerve, autografts are the preferred treatment. Although absorbable sutures are not recommended for nerve repair, there is no evidence that non-absorbable sutures are superior to absorbable sutures. This study aims to assess the effectiveness of non-absorbable monofilament nylon sutures, absorbable monofilament vicryl sutures, and fibrin glue when used for nerve grafting. METHODS: Lewis rats (N = 32) were subjected to a sciatic nerve transection and randomly assigned to a group: graft with Nylon, graft with Vicryl, graft with Fibrin Glue, or no graft. Motor function, sensory function, and thermal pain were assessed during a 12-week recovery period, and immunohistochemistry was used to assess macrophage response. RESULTS: At 12 weeks, the Vicryl and Nylon groups had significantly larger ankle angles at to lift off, which is a measure of motor function, compared to injured controls (p < 0.05). Grafted rats displayed no difference in thermal response but hypersensitivity to mechanical stimuli compared to the uninjured hindlimb. The Nylon, Vicryl, and Fibrin Glue groups all had significantly less atrophy of the gastrocnemius muscle compared to injured controls (p < 0.0001). In the Fibrin Glue group, 3/9 grafts did not incorporate. The Nylon group had significantly less (p = 0.0004) axon growth surrounding the suture holes compared to the Vicryl group. There were no differences in the axon counts, motor neurons, or sensory neurons between all grafted rats. CONCLUSIONS: These results demonstrate that vicryl sutures work just as well as nylon for nerve recovery after injury and grafting.

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PURPOSE: Population-based studies on abnormal binocular vision and low literacy are rare. The aim is to determine the prevalence of poor stereoacuity among children with low literacy; to identify the characteristics associated with poor stereoacuity among children with low literacy; and to determine the agreement between poor stereoacuity as measured by graded stereocircles with a computerized assessment. METHODS: A total of 490 children attending primary school in the greater Hobart region, Tasmania, aged 7 to 14 years, with literacy results below the 10th percentile for Tasmanian students at grade 3 level of the NAPLAN (National Assessment Program in Literacy and Numeracy) testing completed a vision screen. Poor stereoacuity was defined as more than 100 seconds of arc as measured by Titmus stereocircles. RESULTS: The prevalence of poor stereoacuity was 16.8% (95% confidence interval [95% CI], 13.6 to 20.4%). Children with poor stereoacuity had a higher frequency of symptom report using the Convergence Insufficiency Symptom Survey. Factors associated with poor stereopsis were prematurity (adjusted odds ratio [AOR], 2.19; 95% CI, 1.09 to 4.42) and bottom shuffling (AOR, 2.39; 95% CI, 1.17 to 4.88). Features associated with poor stereopsis included squint (AOR, 6.05; 95% CI, 3.02 to 12.12), migraine (AOR, 2.25; 95% CI, 1.05 to 4.83), and attention deficit disorder (AOR, 1.92; 95% CI, 1.01 to 3.65). CONCLUSIONS: In this low-literacy sample, one-sixth had low stereoacuity. The associations reported require further investigation.

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PURPOSE: To assess, among children with low literacy and poor stereoacuity, the efficacy of two intervention programs on child vision and education compared to a control program. METHODS: Eighty-eight children aged 8 to 13 years who had reading problems, and demonstrated poor stereoacuity as measured by the Titmus stereocircle test (> 100 seconds arc) or computerized assessment were randomized to one of two intervention programs: Lawson vision or Phono-Graphix, or a control group: Parental Literacy Support. Vision (Lang test, visual acuity, convergence insufficiency symptom survey) and education assessments (Woodcock Reading Mastery Tests-Revised) were conducted at baseline, intervention end (10 weeks), and 36 weeks. Analysis used intention to treat multi-level models. RESULTS: Compared to the parental literacy support group, convergence insufficiency symptoms were reduced 36 weeks post-randomization amongst those receiving the Lawson orthoptic intervention (mean difference -5.55; 95% confidence interval (CI): -11.1 to -0.05, P < 0.05). Stereoacuity, measured by the Lang test, improved for both the Lawson and Phono-Graphix interventions compared to the parental literacy support group (-1.01; 95% CI: -1.6 to -0.4, P = 0.001, and -0.77; 95% CI: -1.4 to -0.2, P = 0.01). At the 36 week follow-up assessment, word identification had also improved for the Lawson and Phono-Graphix groups but other educational outcomes did not improve. CONCLUSION: A formal randomized control trial was feasible in this setting. Intervention among children with poor stereoacuity and low literacy produced small improvements in stereopsis and convergence insufficiency symptom scores. Further randomized control trials should be conducted to clarify the role of orthoptic intervention on literacy in selected child populations.

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