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The efficacy of a simplified intraoperative adjustable suture for horizontal strabismus surgery: a prospective study of 49 patients

PURPOSE: To evaluate the efficacy of a simplified intraoperative adjustable suture technique, under general anesthesia (GA) proposed by the authors. METHODS: A prospective study of 49 patients with horizontal strabismus, 22 esotropes and 27 exotropes. The same surgeon (MP) operated on all of the patients. The corneal light reflection was measured in millimeters (mm) from the limbus preoperatively and under GA: the esotropes from the temporal border and the exotropes from the nasal border. The adjustment was made or not based on these two measures if there was or not a difference between them. The authors calculated the adjustment on the measures in mm, not converting them in to prism diopters (PD) or taking the pupil as a reference point. RESULTS: 28 patients (57.1%) had the eye position modified under GA. In 25 of all of them (51.0%) surgery was adjusted. Surgical success was defined as orthotropia, eso- or exodeviation up to 10 PD, in a follow-up period of at least 6 months. The overall success rate was 75.6%. CONCLUSION: Results suggested this simplified procedure is effective. As an adjustable technique can conduct to more predictable outcomes, and being a simplified technique it can be employed in more cases, specially because it can be carried out by surgeons not used to the adjustable suture techniques.

Suture techniques; Anesthesia general; Strabismus; Esotropia; Exotropia; Prospective studies; Adult


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