Purpose: To assess the short term success rate of adjustable suture technique
on rectus muscle strabismus surgery in terms of postoperative alignment
Study Design: Prospective, interventional study
Place and Duration of Study: Eye Department, Fauji Foundation Hospital,
Rawalpindi, from 25th June, 2016 to 25th December, 2017
Material and Methods: We carried out a study using the fornix approach for
adjustable squint surgery, in mainly horizontal strabismus in adults and
cooperative children, to finely tune the postoperative alignment. The
preoperative deviation, strabismus type, patterns, were measured and analyzed.
The early postoperative alignment was measured at 6 weeks postoperatively, to
assess the success of the adjustable suture technique. A sliding noose knot was
used to adjust the sutures, 1 hour postoperatively under topical proparacaine
anesthesia, after the effects of general anesthesia had worn off.
Results: 31 patients were included in this study. The majority were female being
23 (74.5%). The age ranged from 9 to 37 years, with the mean age 16.87 ± 5.5
years. All consenting adults and teenagers, with strabismus were included in this
study and operated via the adjustable suture technique. The mean preoperative
deviation was 49.38 ± 16.29 Δ prism diopters, and the mean postoperative
deviation was 3.5 ± 5.42Δ prism diopters. The difference between the two was
statistically significant (p < 0.05), using the Wilcoxon Signed Ranks test (p =
0.000). Early surgical success defined as alignment within ± 10Δ (prism diopters)
of orthotropia at the end of 6 weeks after surgery, was found in 27 (87.1%) of our
strabismus cases.
Conclusion: Adjustable strabismus surgery is associated with excellent shortterm postoperative outcomes in terms of alignment and patient satisfaction.
Adjustable sutures should be considered in all strabismus cases, whether adults
or children.