Adjustable suture strabismus surgery in infants and children

Purpose: To evaluate the success rate of adjustable suture techniques in horizontal eye muscle surgery in children aged 10 years and younger. Methods: A retrospective review of children who had horizontal eye muscle surgery at or before the age of 10 years. Patients were divided into 1 of 2 groups according to whether a nonadjustable or an adjustable technique was used. The preoperative measurements, type of strabismus, and postoperative results were analyzed. Results: A total of 98 cases in the nonadjustable group and 298 cases in the adjustable group were identified. Early success rate, defined as alignment within 8^Δ of straight at the end of 3 months, was notably greater in the adjustable group (79%) than in the nonadjustable group (64.5%). The difference was statistically significant (p < 0.01). In the adjustable group, adjustment was performed in 64% of the cases, either because of an undercorrection or overcorrection. The adjustment procedure was performed under topical proparacaine in 20% of cases and under intravenous propofol in 80%. No complications were reported during the adjustment procedure. Conclusions: The use of adjustable sutures can provide an improved success rate over nonadjustable sutures in eye muscle surgery in children aged 10 years or younger.