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.

Strabismus Surgery with Adjustable Suture Technique in Patients with Horizontal Strabismus

“…The findings of the current study are in line with the data earlier published. 13,14 Nevertheless, the technique has been improvised, resulting in better patient outcomes and satisfaction. 15 We did not encounter any slipped muscle, and we did not face any significant difficulty in performing muscle adjustment.…”

“…They reported that the adjustable suture technique produced statistically significant and better surgical outcomes for patients with exotropia and esotropia. 13 Bishop and Doran evaluated the outcome of strabismus surgery with adjustable sutures retrospectively. They reported successful outcomes in 81% of patients.…”

<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.…”