Efficacy and safety of adjustable suture in horizontal strabismus: Comparative study of children versus adults

• Published in: Archivos de la Sociedad Española de Oftalmología (English ed.) 2022-09, Vol.97 (9), p.483-489
• Main Authors: Carreño C., D., Burgos-Blasco, B., Gómez de Liaño, R., Dávila T., A., Cañizares, R., Zúñiga Menéndez, J., Carreño C., J.
• Format: Article
• Language: English
• Subjects: Adjustable suture; Adultos; Adults; Children; Estrabismo; Niños; Strabismus; Sutura ajustable
• ISSN: 2173-5794; 2173-5794
• DOI: 10.1016/j.oftale.2022.06.013

Adjustable suture procedures allow addressing the unpredictability of some postoperative results in strabismus surgery. The purpose of the study was to compare the effectiveness of adjustable and non-adjustable suture in the treatment of horizontal strabismus in children and adults. Prospective study including patients undergoing strabismus surgery to correct horizontal strabismus with fixed hanging suture (non-adjustable suture group) and adjustable suture. Visual acuity, amblyopia, deviation, oblique muscle involvement, previous surgeries, nystagmus, need for adjustment, and complications were recorded. The variables were recorded in the immediate postoperative period, at one week and at 3 and 6 months. 186 patients were included: 157 (84.4%) with adjustable suture and 29 (15.6%) with non-adjustable suture, of which 119 were children and 67 were adults. Postoperatively, 19 children (16.0%) and 19 adults (28.4%) required adjustment (p = 0.044). Of 157 patients with adjustable suture, it was adjusted in 20% (32/157). Success after adjustment was higher for adjustable suture (91.72% vs 79.31%; p = 0.043) and remained for 6 months (p < 0.05). Previous surgery (p = 0.004) and exotropia (p = 0.018) correlated with the need for adjustment. 20% of patients with horizontal strabismus can benefit from a postoperative adjustment to improve the surgical result. The adjustable suture was shown to be superior to the fixed hanging suture and is an excellent surgical option, both in children and adults. Los procedimientos con sutura ajustable permiten abordar la imprevisibilidad de algunos resultados postoperatorios en la cirugía de estrabismo. El propósito del estudio fue comparar la efectividad de la sutura ajustable y no ajustable en el tratamiento del estrabismo horizontal en niños y adultos. Estudio prospectivo en el que se incluyeron pacientes sometidos a cirugía de estrabismo para la corrección de un estrabismo horizontal con sutura colgante fija (grupo de sutura no ajustable) y sutura ajustable. Se registró la agudeza visual, la ambliopía, la desviación, la afectación de músculos oblicuos, cirugías previas, el nistagmo, la necesidad de ajuste y las complicaciones. Las variables se registraron en el postoperatorio inmediato, a la semana y a los 3 y 6 meses. Se incluyeron 186 pacientes: 157 (84.4%) con sutura ajustable y 29 (15.6%) con sutura no ajustable, de los cuales 119 eran niños y 67 adultos. En el postoperatorio, 19 niños (16,0%) y 19 adultos (28,4%) requir