Adjustable versus non-adjustable suture techniques for concomitant horizontal strabismus: a comparative study

ABSTRACT Purpose: To compare the surgical results of adjustable and non-adjustable horizontal strabismus surgery for concomitant horizontal strabismus. Methods: The charts of 231 patients, who underwent horizontal strabismus surgery, selected using probabilistic sampling, were retrospectively reviewed. Patients were divided into two groups according to the surgical technique used and strabismus type. The adjustable suture technique was used for 107 patients (Group 1), and non-adjustable or conventional surgery was performed in the remaining 124 patients (Group 2). Patients with esotropia (ET) or exotropia (XT) of 5 PD, syndromes, restrictive or paretic strabismus, reoperations, botulinum toxin injection, and patients postoperatively followed up for 50% was present in all subgroups. Significant differences between strabismus groups submitted to adjustable technique and non-adjustable on postoperative day 1 were observed (p=0.00 for ET and p=0.01 for XT) and at the last visit for the XT group with a follow-up of at least 1 year (p=0.05). Conclusion: The adjustable suture technique produced a higher success rate than non-adjustable strabismus surgery for both ET and XT groups on postoperative day 1. For XT patients, the adjustable suture technique appears to produce better surgical results than non-adjustable surgery, when the surgical goal is long-lasting maintenance of a small hypercorrection.

摘要
目的：对比共同性水平斜视患者采用可调节缝线与非调节缝线水平斜视手术的手术效果。
方法：采用概率抽样法选取231例行水平斜视手术患者的病历资料进行回顾性分析。根据手术方式与斜视类型将患者分为两组：107例采用可调节缝线技术（组1），剩余124例采用非调节缝线或传统手术方式（组2）。所有亚组均纳入内斜视（esotropia, ET）、外斜视（exotropia, XT）度数达5三棱镜度（PD）、合并综合征、限制性或麻痹性斜视、存在再次手术史、接受过肉毒杆菌毒素注射的患者，且所有亚组的术后随访达标率为50%。术后第1天，采用可调节缝线技术与非调节缝线技术的斜视组间存在显著差异（内斜视组p=0.00，外斜视组p=0.01）；随访至少1年的外斜视组末次随访时两组亦存在显著差异（p=0.05）。
结论：术后第1天，无论内斜视组还是外斜视组，可调节缝线技术的手术成功率均高于非调节缝线斜视手术。当手术目标为长期维持轻度过矫状态时，外斜视患者采用可调节缝线技术可获得优于非调节手术的手术效果。