Comparison of adjustable sutures versus nonadjustable sutures in intermittent exotropia

Kamlesh, .; Babu, S. Suresh; Goel, Yashpal; Chaudhary, Rupak; Rastogi, Anju; Agarwal, Richa; Dhiman, Shweta; Kumar, Prateek; Bharadwaj, Ankita

doi:10.5301/ejo.5001063

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…Of the 18 studies ultimately selected for inclusion in this review, the database search revealed just two randomized controlled trials (RCT) comparing the results of AS versus NAS [7,8]. The first study included 60 children with an average age of 3.5 randomized into AS and NAS groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The author believes that the interpretation of the results of clinical research on the subject of AS versus NAS must go beyond just statistics. Concentrating solely on RCTs will not provide any conclusions, as so far only two such studies were performed [7,8]. Authors of recent Cochrane Database Systemic Reviews on AS versus NAS in strabismus surgery were not able to present any reliable thesis due to the scarceness of randomized studies on the subject [24].…”

Section: Discussionmentioning

confidence: 99%

“…Only three studies suggested statistically better results of surgery were achieved with the use of AS [9][10][11]. The remaining four studies did not prove the statistical superiority of either of the two surgical methods over the other [8,[12][13][14].…”

Section: Postoperative Success Ratementioning

confidence: 94%

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Adjustable Versus Nonadjustable Sutures in Strabismus Surgery—Who Benefits the Most?

Gawęcki¹

2020

JCM

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Background: Adjustable sutures have been used in strabismus surgery for more than 40 years, but controversy remains regarding their application. This review sought to analyze studies comparing the efficacy of adjustable sutures (AS) and nonadjustable sutures (NAS) in the treatment of different ocular deviations. Materials and Methods: The PubMed literature database was searched using the keywords ‘adjustable sutures’ and ‘strabismus surgery’, yielding a total of 209 results. Only comparative studies were extracted, and the results were divided into three categories: Adult comitant strabismus, childhood comitant strabismus, and paretic/restrictive strabismus. Results: The search revealed eleven comparative studies on AS versus NAS in adult strabismus, including only one randomized controlled trial. Five of these studies analyzed just the postoperative success rate, three studies analyzed just the reoperation rate, two studies analyzed both the postoperative success and reoperation rates, and one study evaluated achievement of the postoperative target angle. Three of seven studies analyzing postoperative success reported the statically significant superiority of AS over NAS, while four of five studies analyzing reoperation rate indicated a significantly smaller percentage of reoperations with the use of AS. The study covering postoperative target angle as an outcome favored the AS technique. Separately, the search revealed three comparative studies on AS versus NAS in childhood strabismus, one of which reported a statistically significant advantage with AS. Only four comparative studies on AS versus NAS in paretic or restrictive strabismus were found; all showed a tendency for better results with the use of AS but not in a statistically significant fashion. Overall, out of 18 studies analyzed in this review, 17 suggested better clinical results followed the application of AS versus NAS; however, only a minority had statistically significant results. Conclusion: The analysis of available research failed to support AS as the preferable surgery technique over NAS in cases of simple and predictive strabismus. Further research is needed to more precisely determine the group of patients able to benefit the most from AS.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Adjustable Versus Nonadjustable Sutures in Strabismus Surgery—Who Benefits the Most?

Gawęcki¹

2020

JCM

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“…Several previous studies recommended adjustment within the immediate postoperative period to prevent the development of potential complications, such as healing of the conjunctiva or adherence of the muscle to the sclera. 5,[17][18][19][20] Nevertheless, Agrawal et al 21 performed adjustment 48 hours after the strabismus surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Exotropia is a common form of strabismus, with an incidence of 1% in the general population. 1 Treatment of exotropia entails either conservative measures or operative correction. When conservative measures fail to correct the condition, lateral rectus recession and/or medial rectus resection constitute the definitive treatment.…”

Section: Introductionmentioning

confidence: 99%

<p>Laser-Assisted Adjustable Suture Technique in Strabismus Surgery</p>

Hannon

El‐Alfy

Elborgy

et al. 2020

OPTH

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Purpose The aim of this study was to assess the efficacy and safety of a new technique (argon laser-assisted lysis of the adjustable suture) in strabismus surgery. Patients and Methods Recession of lateral rectus muscle was done and was secured to the sclera at the predetermined recession position after suspending it 1.5–2.5 mm farther. A 10-0 nylon suture was placed at the original insertion site, passed under the previously tied muscle suture knot, and tied, advancing the muscle to the new scleral insertion. Postoperatively in the same day of surgery, if the targeted slight overcorrection was not achieved, a topical anesthetic was given, and argon laser was used to cut the nylon suture providing additional muscle recession. Results Forty-two patients with exotropia were included: 11 children and 31 adults. Eleven (26.2%) patients became orthophoric immediately following muscle recession. Thirty-one (73.8%) patients were undercorrected with a mean residual angle of 8.2±3.3 pd. After laser-assisted release of the suture, 12 (28.6%) patients were orthophoric, with 4 (9.5%) patients still undercorrected and 26 (61.9%) patients overcorrected. By the end of 6 months postoperatively, the overall success rate of the procedure was 88.1%, with only 5 (11.9%) patients with exotropia. Conclusion The laser-assisted adjustable suture technique had an overall success rate of 88.1% with only 11.9% of the patients showing exotropia. The technique can help achieve successful alignment.

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Long-term outcomes of adjustable strabismus surgery at a Pakistani university hospital

Nadeem

2022

Int Ophthalmol

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Comparison of adjustable sutures versus nonadjustable sutures in intermittent exotropia

Abstract: Adjustable hang-back recession has no definite added advantage over nonadjustable hang-back recession in intermittent exotropia.

Cited by 8 publications

References 10 publications

Adjustable Versus Nonadjustable Sutures in Strabismus Surgery—Who Benefits the Most?

Adjustable Versus Nonadjustable Sutures in Strabismus Surgery—Who Benefits the Most?

<p>Laser-Assisted Adjustable Suture Technique in Strabismus Surgery</p>

Long-term outcomes of adjustable strabismus surgery at a Pakistani university hospital

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