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One-Month Postoperative Horizontal Strabismus Surgery Outcomes Using Adjustable and Nonadjustable Sutures.

Dan Liu1, Aman Kumar1, David Shieh1

  • 1Department of Ophthalmology, Albany Medical College , Albany, New York.

Journal of Binocular Vision and Ocular Motility
|June 9, 2020
PubMed
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Adjustable sutures (AS) in adult strabismus surgery did not show improved alignment or success rates compared to nonadjustable sutures (NAS) in this retrospective study. Further research is needed to evaluate long-term outcomes.

Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Strabismus Surgery

Background:

  • Adjustable sutures (AS) are often suggested to improve outcomes in adult strabismus surgery compared to nonadjustable sutures (NAS).
  • However, the clinical significance and justification for the added time and discomfort of AS remain debated.

Purpose of the Study:

  • To compare the clinical effectiveness of adjustable sutures (AS) versus nonadjustable sutures (NAS) in adult horizontal strabismus surgery.
  • To determine if AS offer significant advantages in ocular alignment and success rates over NAS.

Main Methods:

  • Retrospective review of 184 adult patients undergoing horizontal strabismus surgery between 2000 and 2014.
  • Comparison of outcomes between AS and NAS groups, with surgeons developing a preference for NAS midway through the study.
Keywords:
Adult strabismusadjustable sutures

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  • Primary outcome: alignment in primary position at 1-2 months postoperatively. Secondary outcome: success rate defined as <10PD residual deviation.

    • Main Results:

    • No significant difference in primary position alignment at 1-2 months was observed between AS and NAS for esotropia (P=.26) or exotropia (P=.10).
    • Success rates were similar for both groups: esotropia (P=.58) and exotropia (P=.34).

    Conclusions:

    • Adjustable sutures (AS) were not associated with improved alignment or success rates compared to nonadjustable sutures (NAS) at 1-2 months postoperatively in this cohort.
    • While AS remain a valuable option, routine use in all adult cases may not be justified based on these findings.
    • A prospective study is recommended to evaluate long-term outcomes of AS versus NAS in strabismus surgery.