Routine use of non-absorbable sutures in bi-medial rectus recession as a measure to reduce the incidence of consecutive exotropia.

Abstract

OBJECTIVE:

To evaluate the incidence of consecutive exotropia following bilateral medial rectus muscle recession surgery (BMR) for esotropia using non-absorbable compared with absorbable sutures in children undergoing strabismus surgery.

METHODS:

A retrospective cohort study of all children with esotropia who underwent BMR by a single surgeon in a tertiary public hospital. As of February 2018, only non-absorbable sutures were used. The primary outcome was the incidence of consecutive exotropia.

RESULTS:

A total of 121 children were included in the analysis, 3.66 ± 2.62 years, 53% were male. In 80 children (66%) non-absorbable sutures were used (non-absorbable group) and in 41 children (34%) absorbable sutures were used (absorbable group). Consecutive exotropia (≥ 8 prism dioptres) occurred in ten children (24%) in the absorbable group and in three children (4%) in the non-absorbable group (OR = 8.28, 95% CI = 2.13-32.13; P = 0.002). This difference between groups remained significant after adjustment for potential confounders and follow-up time (HR = 4.98, 95% CI = 1.30-19.05, P = 0.019). Mean follow-up time was 22 and 12 months in the absorbable and non-absorbable groups, respectively (P < 0.001). Two children in the non-absorbable group had pyogenic granuloma that resolved after 3 months of topical steroidal therapy.

CONCLUSION:

Routine use of non-absorbable sutures in BMR surgery for esotropia may be a preferable alternative to absorbable sutures for the prevention of consecutive exotropia.

• Authors: Biana Dubinsky-Pertzov, Adi Einan-Lifshitz, Eran Pras, Morris E Hartstein, Yair Morad
• Journal: Eye (London, England) (Eye (Lond)) Vol. 36 Issue 9 Pg. 1772-1776 (09 2022) ISSN: 1476-5454 [Electronic] England
• PMID: 34373609 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

Topics

• Child
• Esotropia (surgery)
• Exotropia (surgery)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Oculomotor Muscles (surgery)
• Ophthalmologic Surgical Procedures (adverse effects)
• Retrospective Studies
• Sutures (adverse effects)
• Treatment Outcome
• Vision, Binocular (physiology)