Comparison of Two Different Extraocular Muscle Suturing Techniques for Strabismus Surgery

Area of Science:

• Ophthalmology
• Surgical Techniques
• Strabismus Surgery

Background:

• Strabismus surgery, including bilateral medial rectus recession (BMR) and bilateral lateral rectus recession (BLR), aims to correct eye alignment.
• Suturing techniques, such as 3-point fixation (3PF) and 2-point fixation (2PF), are critical in achieving desired surgical outcomes.
• Overcorrection and undercorrection are common complications that can necessitate further surgical intervention.

Purpose of the Study:

• To compare the surgical outcomes of BMR and BLR procedures using 3-point fixation (3PF) versus 2-point fixation (2PF) suturing techniques.
• To evaluate the efficacy of different fixation techniques in minimizing overcorrection and undercorrection/recurrence.
• To identify the optimal suturing method for improved patient outcomes in horizontal rectus muscle recession surgery.

Main Methods:

• A prospective clinical cohort study involving 248 patients with concomitant esotropia or exotropia.
• Patients underwent either BMR or BLR using either 3PF or 2PF suturing techniques.
• Postoperative deviation angles were recorded, and a Cox proportional hazards model analyzed the association between suturing techniques and surgical outcomes, focusing on overcorrection and undercorrection/recurrence.

Main Results:

• The cumulative incidence of overcorrection was significantly higher in the 2PF group (33.72%) compared to the 3PF group (13.09%).
• The 3PF technique was associated with a 62% decreased risk of overcorrection compared to the 2PF technique (HR = 0.38).
• No significant difference was observed in the cumulative incidence of undercorrection/recurrence between the 3PF and 2PF groups.

Conclusions:

• The 3-point fixation (3PF) suturing technique demonstrates superior efficacy in reducing overcorrection rates following bilateral horizontal rectus muscle recession surgery.
• 3PF is recommended as a preferred alternative to 2PF for minimizing overcorrection in these procedures.
• Further research may explore long-term outcomes and patient satisfaction with both techniques.