Improved Ocular Alignment with Adjustable Sutures in Adults Undergoing Strabismus Surgery

Zhang, Monica S.; Hutchinson, Amy K.; Drack, Arlene V.; Cleveland, Julia; Lambert, Scott R.

doi:10.1016/j.ophtha.2011.07.044

Cited by 48 publications

(45 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17 Many studies have found adjustable sutures to be a beneficial technique. [18][19][20] In our study, patients who underwent strabismus surgery with adjustable sutures were more likely to have a successful outcome (adjustable, 63%; no adjustable, 38%), but this difference did not quite reach significance (p = 0.06), likely due to the small sample size.…”

Section: Discussioncontrasting

confidence: 56%

Predictors of Good Motor and Sensory Outcomes Following Strabismus Surgery for Patients with Third Nerve Palsies

Peragallo¹,

Hutchinson²,

Lenhart³

et al. 2014

Neuro-Ophthalmology

Self Cite

View full text Add to dashboard Cite

Strabismus from third nerve palsy (3NP) is difficult to treat. Our goal was to explore factors associated with successful surgical outcomes in 3NP. Institutional records of all adult patients (418 years) from 1988 to 2012 with 3NP who underwent strabismus surgery or botulinum toxin injections were retrospectively reviewed. Success was defined as absence of diplopia, vertical deviation 2 prism dioptres (PD), and horizontal deviation 10 PD. Fifty-six patients from four surgeons were included. Thirty (54%) were female; mean age was 48 (range: 20-80). Forty-four (79%) had unilateral 3NP; 9 (16%) had other ocular motor nerve palsies. 3NP were complete in 24 (43%). Underlying aetiology was idiopathic/microvascular in 5 (9%), traumatic in 13 (23%), neoplastic in 12 (21%), aneurysmal in 10 (18%), and other central nervous system related in 16 (29%). Trauma was associated more frequently with aberrant regeneration than other aetiologies: 9/13 (69%) versus 4/43 (9%) (p50.01). Ten patients (18%) had 41 surgery. Surgical success was achieved in 28/56 (50%). Success rate was unaffected by aetiology, degree of palsy, pupillary involvement, presence of aberrant regeneration, or number of other cranial nerves involved. However, adjustable sutures were used in 27 patients (48%), and there was a trend toward higher success rates when adjustable versus nonadjustable sutures were used (63% versus 38%; p = 0.06). Unlike with sixth nerve palsies, the aetiology and degree of 3NP does not appear to affect the success rates or number of procedures performed. Strabismus surgeries for 3NP with adjustable sutures may be associated with better outcomes.

show abstract

Section: Discussioncontrasting

confidence: 56%

Predictors of Good Motor and Sensory Outcomes Following Strabismus Surgery for Patients with Third Nerve Palsies

Peragallo¹,

Hutchinson²,

Lenhart³

et al. 2014

Neuro-Ophthalmology

Self Cite

View full text Add to dashboard Cite

show abstract

“…18 However, many other studies have found a benefit to the adjustable suture technique. [19][20][21] Outcomes of the use of adjustable sutures specifically for abducens paresis has not been previously evaluated to our knowledge. We found that patients who underwent adjustable sutures were more likely to have a successful outcome (71% versus 49%), but this difference was not statistically significant, likely due to our small sample size.…”

Section: Discussionmentioning

confidence: 99%

Functional and Motor Outcomes of Strabismus Surgery for Chronic Isolated Adult Sixth Nerve Palsy

Peragallo¹,

Hutchinson²,

Lenhart³

et al. 2014

Neuro-Ophthalmology

Self Cite

View full text Add to dashboard Cite

Abducens nerve palsy is the most common acquired ocular motor nerve palsy in adults. Chronic cases of abducens palsy often require surgical intervention to relieve disabling diplopia. The goal of this study was to identify factors associated with surgical outcomes in isolated abducens palsy. Medical records of all adult patients from 1988 to 2012 with abducens palsies who underwent strabismus procedures were retrospectively reviewed. Motor alignment, extraocular motility, and sensory outcomes were recorded. Success was defined as absence of diplopia without prisms or face turn, vertical deviation 2 prism dioptres (PD), and horizontal deviation 10 PD. Eighty-one patients (age range: 20-86 years) met inclusion criteria. Success was achieved in 58% of patients. Final success rates for abducens palsy were 50% for neoplastic, 59% traumatic, 57% for microvascular/unknown, and 67% for other central nervous system causes (p40.05). Patients with an underlying neoplastic or traumatic aetiology required more than one strabismus procedure more often than those with microvascular/idiopathic or other central nervous system causes (48% vs. 24%; p = 0.03). For complete abducens palsies, patients who underwent Hummelsheim-type procedures had a higher success rate than those who underwent a full-tendon vertical rectus muscle transposition. (78% versus 35%; p = 0.049). Success rates for strabismus procedures in patients with abducens palsies are similar across all aetiologies. Frequency of re-operation is higher among those patients with neoplastic or traumatic aetiologies for their abducens palsies. Hummelsheim-type procedures have a higher success rate for complete abducens palsies than full-tendon vertical rectus transpositions.

show abstract

“…6 Zhang et al studied two surgeons who frequently used adjustable sutures and one surgeon who did not. 11 Another recent study noted a higher success rate in patients who selected adjustable sutures compared with patients who did not. 12 Demonstrations of adjustable suture efficacy from the retrospective literature have limitations.…”

Section: Introductionmentioning

confidence: 99%

Strabismus Surgery Reoperation Rates With Adjustable and Conventional Sutures

Leffler

Vaziri²,

Cavuoto³

et al. 2015

American Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To determine the association of strabismus surgery reoperation rates with adjustable or conventional sutures. Design Retrospective cross-sectional study. Methods Setting Review of a large national private insurance database. Study Population Adults age 18 to 89 having strabismus surgery between 2007 and 2011. Intervention Adjustable versus conventional suture strabismus surgery. Outcome Measure Reoperation rate in the first postoperative year. Results Overall, 526 of 6178 surgical patients had a reoperation (8.5%). Reoperations were performed after 8.1% of adjustable suture surgeries and after 8.6% of conventional suture surgeries (p=0.57). Of the 4357 horizontal muscle surgeries, reoperations were performed after 5.8% of adjustable suture surgeries, and after 7.8% of conventional suture surgeries (p=0.02). Of the 1072 vertical muscle surgeries, reoperations were performed after 15.2% of adjustable suture surgeries, and after 10.4% of conventional suture surgeries (p=0.05). Younger age (18 to 39 years) was associated with a lower reoperation rate (p ≤ 0.02). The significant multivariable predictors of reoperation for horizontal surgery were adjustable sutures (odds ratio, OR 0.69, 95% confidence interval 0.52 to 0.91), monocular deviation (OR 0.64), complex surgery (OR 1.63), and unilateral surgery on two horizontal muscles (OR 0.70, all p ≤ 0.01). Adjustable sutures were not significantly associated with reoperation rates after vertical muscle surgery (multivariable OR 1.45, p=0.07). Conclusions Adjustable sutures were associated with significantly fewer reoperations for horizontal muscle surgery. Adjustable sutures tended to be associated with more reoperations for vertical muscle surgery, but this observation was not statistically significant in the primary analysis after controlling for age.

show abstract

Improved Ocular Alignment with Adjustable Sutures in Adults Undergoing Strabismus Surgery

Cited by 48 publications

References 24 publications

Predictors of Good Motor and Sensory Outcomes Following Strabismus Surgery for Patients with Third Nerve Palsies

Predictors of Good Motor and Sensory Outcomes Following Strabismus Surgery for Patients with Third Nerve Palsies

Functional and Motor Outcomes of Strabismus Surgery for Chronic Isolated Adult Sixth Nerve Palsy

Strabismus Surgery Reoperation Rates With Adjustable and Conventional Sutures

Contact Info

Product

Resources

About