Improved Ocular Alignment with Adjustable Sutures in Adults Undergoing Strabismus Surgery

• Authors: Monica S. Zhang, Emory University; Amy K Hutchinson, Emory University; Arlene V. Drack, University of Iowa; Julia Cleveland, Emory University; Scott R Lambert, Emory University
• Journal Title: Ophthalmology (Section 12 EMBASE)
• Volume: Volume 119, Number 2
• Publisher: Elsevier | 2012-02, Pages 396-402
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.ophtha.2011.07.044
• Subjects: Health Sciences, Opthamology

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: Five hundred thirty-five adults who had strabismus surgery between 1989–2010. 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: 491 patients met the inclusion criteria (adjustable suture, n=305; non-adjustable, n=186). The success rates for non-adjustable and adjustable groups were 61.3% and 74.8% respectively (χ2=9.91, p=0.0016). Adjustable suture use was particularly beneficial for patients undergoing a reoperation for childhood strabismus (success rate: non-adjustable, 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 (non-adjustable, 65.0%; adjustable, 81.4% p=0.1354; n=90) or with thyroid orbitopathy (non-adjustable, 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 to strabismus surgery without the use of adjustable sutures. Adjustable sutures were most beneficial for patients undergoing reoperations for childhood strabismus.