Outcomes of adjustable strabismus surgery in an Irish University Hospital

Strabismus surgery aims to improve binocular vision, reduce diplopia, and enhance cosmesis. Adjustable strabismus procedures have been developed as a means of tackling unpredictability in some post-operative results. The purpose of the study was to compare the effectiveness of adjustable and non-adjustable squint procedures in the treatment of strabismus.

We analyzed adjustable or non-adjustable squint surgery undergone in our Irish locality by retrospectively studying 27 consecutive patients at Mater Misericordiae University Hospital, Dublin.

There was no significant difference (p = 0.519) in the mean post-operative horizontal deviation between the adjustable group (mean = 11.6 PD) and the non-adjustable group (mean = 15.3 PD). We found that adjustable procedures resulted in a trend (p = 0.050) towards a greater mean horizontal effect per muscle (18.9 PD per muscle) than non-adjustable procedures (mean 9.7 PD). We went on to analyze the adjustable group in order to determine the impact on outcome in those patients in whom their adjustable sutures were manipulated postoperatively. Of the 11 patients who underwent adjustable procedures, 6 subsequently had adjustments made as planned and 5 did not require adjustment. Those patients who had their sutures adjusted demonstrated a smaller mean post-operative deviation (8.5 PD) than those patients in whom their suture was not adjusted (mean = 16.3 PD).

Our study displays a trend that adjustable procedures are more effective in terms of the mean horizontal effect per muscle operated, and is a novel way of reporting effectiveness of strabismus procedures.