Adjustable and non-adjustable strabismus surgery: a retrospective case-matched study

Area of Science:

• Ophthalmology
• Surgical Techniques
• Strabismus Surgery

Background:

• Adjustable suture strabismus surgery was developed for complex cases but is increasingly used routinely.
• The routine application of adjustable sutures necessitates evidence of patient benefit.
• Thyroid eye disease is a specific context where adjustable sutures may be beneficial.

Purpose of the Study:

• To compare the outcomes of adjustable suture strabismus surgery with non-adjustable techniques in patients without thyroid eye disease.
• To determine if adjustable sutures offer a significant advantage in terms of surgical success and deviation correction.

Main Methods:

• Retrospective analysis of matched data comparing adjustable and non-adjustable strabismus surgery.
• Matched pairs based on strabismus type, etiology, deviation magnitude, age, and surgical history.
• Analysis of pre- and post-operative deviation angles, post-operative drift, and defined success criteria.

Main Results:

• No significant difference in mean pre- and post-operative angles of deviation between the two groups.
• Success rates were comparable: 81% for adjustable and 88% for non-adjustable strabismus surgery.
• The study was underpowered to detect statistically significant differences in outcomes.

Conclusions:

• Current evidence does not support the routine use of adjustable suture strabismus surgery in patients without thyroid eye disease.
• The longer, potentially uncomfortable procedure requires demonstrated patient benefit to justify its increasing use.
• A prospective randomized controlled trial is indicated to definitively assess the benefits of adjustable suture strabismus surgery.