Delayed adjustable sutures: a multicentred clinical review

Robbins, Shira L.; Granet, David B.; Burns, Christine L.; Freeman, Robert; Eustis, H. Sprague; Yafai, S; Cruz, Fay Charmaine; Danylyshyn-Adams, K; Langham, Kathryn A.

doi:10.1136/bjo.2009.169987

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…Nihalani et al proposed short tag noose technique, which avoids the need for sedation in patients who do not require adjustment [38]. Robbins et al described similar closed conjunctival delayed adjustable technique [39], and Budning et al also similar short adjustable suture technique [40].…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

Gawęcki¹

2020

JCM

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“…Therefore authors have relied on retrospective studies to demonstrate a benefit for adjustable suture surgery 2 3 10 13 14. The entire premise of using adjustable sutures depends on whether long-term success can be based on achieving the ideal initial ‘target range’.…”

Section: Discussionmentioning

confidence: 99%

Achieving postoperative target range increases success of strabismus surgery in adults: a case for adjustable sutures?

et al. 2015

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“…This is in agreement with another large series of 440 patients published by Robbins et al The mean time to adjustment in his study was 2.5 days (0.96–5.8 days) and no early scleral adhesions were noted. [6] As we have previously mentioned, it may be easier to examine very young children a day or two after surgery. All children went home the day after surgery.…”

Section: Discussionmentioning

confidence: 99%

Outcome of delayed adjustable strabismus surgery in children using a bow-tie optional adjustable technique

Muralidhar¹,

Churawan²,

Sekar³

et al. 2019

Indian J Ophthalmol

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Purpose: The aim of this article is to study the feasibility of a delayed adjustable technique of strabismus surgery in children using an optional adjustable suture technique. Methods: The retrospective study included patients <12 years of age. Recessions were done using an optional adjustable bow-tie technique and resections were done by the conventional technique. Patients were evaluated on the third postoperative day and adjustments done when needed. Statistical analysis was done using Microsoft Excel 2010®. Results: The study included 11 patients with exotropia and 16 patients with esotropia. The mean age of the patients was 5.2 years (range 1–11 years). The mean preoperative distance deviation was 46.7 ± 10.4 prism diopters (PD) for exotropic patients and 47.1 ± 16.9 PD for esotropic patients. The mean preoperative near deviation was 46.6 ± 11 PD for exotropic patients and 52.4 ± 17.1 PD for esotropia. Two patients with exotropia (18.2%) and four patients with esotropia (25%) were adjusted under intravenous ketamine in the operating room under anesthetist supervision. No difficulty was encountered in advancing/recessing the muscles. The success rate at 1 month was 100% for exotropia and 87.5% for esotropia. The success rate at the final follow-up was 81.8% for patients with exotropia and 68.7% for patients with esotropia. Conclusions: This delayed optional adjustable strabismus surgery technique provides good short-term results and lower adjustment rates.

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Delayed adjustable sutures: a multicentred clinical review

Abstract: This large multicentred series characterises the closed conjunctival delayed adjustable suture technique for the correction of strabismus. It may present some significant advantages to more traditional adjustable suture techniques.

Cited by 13 publications

References 26 publications

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

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

Achieving postoperative target range increases success of strabismus surgery in adults: a case for adjustable sutures?

Outcome of delayed adjustable strabismus surgery in children using a bow-tie optional adjustable technique

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