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

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.
• 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.