Adjustableversusnon-adjustable suture techniques for concomitant horizontal strabismus: a comparative study

Abstract

Purpose: To compare the surgical results of adjustable and non-adjustable horizontal strabismus surgery for concomitant horizontal strabismus. Methods: The charts of 231 patients, who underwent horizontal strabismus sur gery, selected using probabilistic sampling, were retrospectively reviewed. Patients were divided into two groups according to the surgical technique used and strabismus type. The adjustable suture technique was used for 107 patients (Group 1), and non-adjustable or conventional surgery was performed in the remaining 124 patients (Group 2). Patients with esotropia (ET) or exotropia (XT) of <55 prism diopters (PD) at distance were included. The following exclusion criteria were applied: all intermittent or vertical deviations, anisotropias >5 PD, syndromes, restrictive or paretic strabismus, reoperations, botulinum toxin injection, and patients postoperatively followed up for <3 months. Surgical success was set to a range between orthotropia and an esodeviation of up to 10 PD for both ET and XT. Results: An amblyopia rate >50% was present in all subgroups. Significant differences between strabismus groups submitted to adjustable technique and non-adjustable on postoperative day 1 were observed (p=0.00 for ET and p=0.01 for XT) and at the last visit for the XT group with a follow-up of at least 1 year (p=0.05). Conclusion:The adjustable suture technique produced a higher success rate than non-adjustable strabismus surgery for both ET and XT groups on postoperative day 1. For XT patients, the adjustable suture technique appears to produce better surgical results than non-adjustable surgery, when the surgical goal is long-lasting maintenance of a small hypercorrection.

<p>Laser-Assisted Adjustable Suture Technique in Strabismus Surgery</p>

“…Zhang et al 26 reported a success rate of 74.8% in adults at 12 weeks after surgery. Vasconcelos et al 27 found that the success rate at 1 year after surgery in patients with exotropia undergoing adjustable suture recession was only 50.0%. Chalifoux et al 18 found that the overall success rate for alignment at 4-6 months postoperatively was 74.6% in patients undergoing adjustable suture technique.…”

Comparison of adjustable sutures versus nonadjustable sutures in intermittent exotropia

“…Vasconcelos and Almeida (7) in their retrospective study concluded that for exotropia patients, the AS technique appears to produce better surgical results than NAS surgery.…”

Vertical Strabismus - Indication of Surgical Techniques on the Inferior Rectus Muscle

“…Po měsíci od operace byly oba operační postupy v úspěšnosti na 60% u esotropie, ale u exotropie stále převládal lepší výsledek u nastavitelných stehů, rovněž v 60% oproti 50% při použití klasického postupu. Tři měsíce po operacích byly oba postupy stejně efektivní u exotropie na necelých 50%, zatímco se u esotropie zlepšilo postavení na 70% u retropozice či myectomie, ale u nastavitelných stehů se stav již nezlepšil ani nezhoršil, zůstal na 60% [31]. Potvrzuje to již dřívější názor autorů české monografie, že s definitivním hodnocením výsledku operací na horizontálních svalech se musí čekat tři měsíce [3].…”