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Updated: Jul 14, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
[Simplified intraoperative adjustable suture technique for horizontal strabismus surgery: a study of 153 cases]
Iara Debert1, Lucia Battistella Passos, Patrícia Grativol Saraiva
1Setor de Motilidade Ocular Extrínseca, Departamento de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil. iaradebert@uol.com.br
Purpose:
To evaluate the simplified intraoperative adjustable suture technique for horizontal strabismus surgery.
Methods:
Data charts of all patients who underwent horizontal strabismus surgery by the simplified intraoperative adjustable suture technique at the Strabismus Department of the "Hospital das Clínicas" of the University of São Paulo in the period from January 2001 to November 2005 were evaluated retrospectively. Using this technique, the adjustment was calculated based on the corneal light reflection, having considered the difference between the measures in the awake state and with the anesthetized patient.
Results:
One hundred fifty-three patients were operated on, 73 (47.8%) cases of esotropia (ET) and 80 (52.2%) of exotropia (XT). Under anesthesia, 123 (80.4%) patients had the eye position modified: 69 (56.1%) were less esotropic, 51 (41.5%) were more exotropic and 3 (2.4%) were less exotropic. Surgery was adjusted in 60 (39.2%) patients: 30 were esotropia and 30 were exotropia. Surgical success was defined as an eso- or exodeviation within 10 prism diopters, in a follow-up period of at least 180 days. The overall success rate was 71.6%.
Conclusions:
The simplified intraoperative adjustable suture technique, described in 2003 in a study performed on 49 patients operated on by the same surgeon, was shown to be efficient in this larger series of patients operated on by different surgeons. This technique should be considered in patients who do not cooperate in other adjustment techniques, aiming at improved success rates.
