Outcomes of inferior rectus muscle recession surgery using absorbable versus non-absorbable sutures

Inferior rectus (IR) recession surgery is commonly performed for vertical strabismus, yet overcorrection risk remains high (21-50%) due to factors like lower lid retractors, suture dissolution, and muscle tension in thyroid eye disease (TED). This study aims to contribute novel insights by comparing clinical outcomes of IR recession using absorbable and non-absorbable sutures.

A retrospective study (01/12/20-31/01/23) was conducted at a tertiary referral center on patients undergoing IR recession with absorbable or non-absorbable sutures. The following data were collected: absorbable vs non-absorbable suture use, age at operation, sex, date of operation, surgical indication, presence of TED, adjustable vs non-adjustable suture technique, surgeon training level, number of muscles recessed, IR distance recessed, and time from surgery to final follow-up.

Thirty-two IR recession procedures were evaluated (26 absorbable, 6 non-absorbable cases) with a mean follow-up of 3.6 months. Both groups achieved similar success in vertical deviation control with no significant difference in success rates for distance (p = .48) or near fixation (p = .21). Overcorrection occurred in 23.1% (absorbable) and 16.7% (non-absorbable) cases, with no statistical difference (p = .61). Logistic regression analysis was performed, which showed that TED (p = .99), surgeon training level (p = .20), adjustable sutures (p = .89) and number of muscles operated on (p = .28) did not significantly impact success for absorbable sutures.

This study demonstrates that IR recession surgeries using absorbable sutures yield outcomes comparable to those using non-absorbable sutures, with no significant difference in success rates and overcorrection rates consistent with existing literature. These findings suggest that absorbable sutures are equally viable in use for IR recession surgeries.