Adjustable Suture Surgery for Correction of Various Types of Strabismus

Abstract

<H4>BACKGROUND AND OBJECTIVE</H4> <P>This study was conducted to analyze the efficacy of the adjustable suture technique for correction of strabismus in patients with different types of strabismus.</P><H4>PATIENTS AND METHODS</H4> <P>This was an observational case series of patients who underwent the adjustable suture technique for correction of strabismus. A total of 33 adult patients (16 males and 17 females) with a minimum postoperative follow-up period of 6 months were included in the study. Patients were analyzed in three groups (patients with exotropia, esotropia, and vertical deviations). Success criteria determined were percentage change in the angle of deviation for far and near fixation, need for reoperation, and relief of diplopia.</P> <H4>RESULTS</H4> <P>The median percentage change in the angle of deviation for far and near fixation was 86.60% and 84%, 92.50% and 94.44%, and 100% and 100% in the exotropia, esotropia, and vertical deviation groups, respectively. There was no need for reoperation, and postoperative adjustment performed 24 hours after surgery was needed in 30.3% of patients due to diplopia.</P> <H4>CONCLUSIONS</H4> <P>The adjustable suture technique seems to be an effective method in the correction of various types of strabismus.</P> <P>[<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2007;38:196-202.]</P> <H4>AUTHORS</H4> <P>From Marmara University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey.</P> <P>Accepted for publication May 9, 2006.</P> <P>Presented in part as a poster at the 29th Meeting of the European Strabismological Association, Izmir, Turkey, June 1-4, 2004.</P> <P>Address correspondence to Sumru Onal, MD, Altunizade Mah., Okulcikmazi Sok. No: 11/5, 34660 Üsküdar, Istanbul, Turkey.</P>

Short Tag Noose Technique for Optional and Late Suture Adjustment in Strabismus Surgery

“…We describe a modification of the existing techniques of adjustable-suture strabismus surgery, [2][3][4][5][6][9][10][11][12][13][14][15][16] which we call the short tag noose adjustable technique. Saunders and O'Neil 11 devised a technique in which postoperative knot tying was required only in patients who underwent adjustment.…”

Surgical outcomes of adjustment on recessed lateral rectus muscle versus resected medial rectus muscle for intermittent exotropia

“…Since the popularization of the adjustment surgery in the 1970s [ 2 , 10 ], many studies have addressed adjustment and focused on introducing different adjustment techniques [ 3 , 11 , 12 ] or demonstrating the effectiveness of the adjustment technique itself by comparing surgical results between adjustment and no adjustment groups [ 13 , 14 ]. In addition, some studies focused specifically on conditions such as adjustment to thyroid-associated strabismus [ 15 ] or all types of strabismus including exotropia, esotropia, and vertical strabismus [ 9 , 16 ]. As strabismus surgery for exotropia, lateral rectus recession or medial rectus resection can be performed.…”

“…There is considerable literature addressing resected muscle adjustment [ 8 , 9 , 12 ]. Hong et al [ 8 ] reported that they resected the rectus muscle and adjusted it in patients with sensory exotropia.…”

“…The authors noted that this technique could prevent over- or under-correction and result in favorable surgical outcomes. In addition, Ogut et al [ 9 ] described that they primarily performed the adjustment surgery on the resected muscle because recession of the muscle using adjustment surgery may be associated with undesired vertical deviation with instability.…”

“…As reported by Wright [ 7 ], it is recognized that the adjustment surgery is generally used for rectus muscle recessions, and many previous reports describing adjustment have addressed adjustments to the recessed muscle [ 3 – 5 ]. Meanwhile, others have suggested that the adjustment surgery is adequate for resected muscle in horizontal strabismus [ 8 , 9 ], and believe that resection using adjustable suture is superior in terms of stability.…”