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Related Experiment Video

Updated: May 14, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
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Surgical Correction for Pediatric Epiblepharon and Trichiasis

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Adjustment versus no adjustment when using adjustable sutures in strabismus surgery.

Laura Liebermann1, Sarah R Hatt, David A Leske

  • 1Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|February 19, 2013
PubMed
Summary

Adjusting adjustable sutures after strabismus surgery did not worsen long-term outcomes. An adjustable approach may offer superior results compared to non-adjustable methods for strabismus alignment.

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Area of Science:

  • Ophthalmology
  • Surgical Techniques

Background:

  • Strabismus surgery often utilizes adjustable sutures to achieve optimal eye alignment.
  • The optimal timing and necessity of intraoperative adjustments for these sutures remain a subject of clinical debate.

Purpose of the Study:

  • To compare long-term postoperative outcomes of adjustable sutures in strabismus surgery when an adjustment is performed versus when sutures are simply tied off at the desired immediate postoperative alignment.

Main Methods:

  • A retrospective review of 89 patients undergoing reoperation for horizontal strabismus using adjustable sutures.
  • Outcomes were assessed at 6 weeks and 1 year, defining success based on angle of misalignment and diplopia.
  • Patients were categorized into 'adjusted' (if alignment correction was needed post-initial tie-off) and 'tied off' (if initial alignment met target without further adjustment) groups.

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Last Updated: May 14, 2026

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Published on: July 8, 2025

Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model
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Main Results:

  • Sixty percent (53/89) of patients required adjustment, while 40% (36/89) did not.
  • Success rates at 1 year showed a trend favoring the adjusted group (77%) over the non-adjusted group (67%), though not statistically significant (P=0.3).
  • At 6 weeks, the adjusted group had a higher success rate (81%) compared to the non-adjusted group (64%), with a trend towards significance (P=0.09).

Conclusions:

  • Performing an adjustment to achieve desired immediate postoperative alignment does not lead to inferior long-term outcomes in strabismus surgery.
  • An adjustable approach, allowing for intraoperative adjustments, may be superior to a non-adjustable approach for achieving stable long-term alignment.