Improved ocular alignment with adjustable sutures in adults undergoing strabismus surgery.

Abstract

OBJECTIVE:

To assess whether outcomes of strabismus surgery are improved by using the adjustable suture technique and to determine which subgroups of strabismus patients benefit most from the adjustable suture technique.

DESIGN:

A retrospective chart review.

PARTICIPANTS:

A total of 535 adults who underwent strabismus surgery between 1989 and 2010.

METHODS:

Success was defined as ≤10 prism diopters (PD) for horizontal deviations and ≤2 PD for vertical deviations. Differences in the proportion of successful strabismus surgery were analyzed using a chi-square test with an alpha of 0.05.

MAIN OUTCOME MEASURES:

Ocular alignment in primary position at a 7-day to 12-week follow-up examination.

RESULTS:

A total of 491 patients met the inclusion criteria (nonadjustable suture, n = 186; adjustable suture, n = 305). The success rates for the nonadjustable and adjustable groups were 61.3% and 74.8%, respectively (χ(2)=9.91, P=0.0016). Adjustable suture use was particularly beneficial for patients undergoing a reoperation for childhood strabismus (success rate: nonadjustable, 42.4%; adjustable, 65.7%; P=0.0268; n = 100). The differences in outcomes were not statistically significant for patients with childhood strabismus undergoing a primary surgery (nonadjustable, 65.0%; adjustable, 81.4%; P=0.1354; n = 90) or with thyroid orbitopathy (nonadjustable, 76.7%; adjustable, 74.1%; P=0.8204; n = 57).

CONCLUSIONS:

Strabismus surgery using adjustable sutures was associated with improved short-term ocular alignment compared with strabismus surgery without the use of adjustable sutures. Adjustable sutures were most beneficial for patients undergoing reoperations for childhood strabismus.

• Authors: Monica S Zhang, Amy K Hutchinson, Arlene V Drack, Julia Cleveland, Scott R Lambert
• Journal: Ophthalmology (Ophthalmology) Vol. 119 Issue 2 Pg. 396-402 (Feb 2012) ISSN: 1549-4713 [Electronic] United States
• PMID: 22036633 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Oculomotor Muscles (physiopathology, surgery)
• Ophthalmologic Surgical Procedures
• Retrospective Studies
• Strabismus (physiopathology, surgery)
• Suture Techniques
• Vision, Binocular (physiology)
• Visual Acuity (physiology)