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J AAPOS. 2008 Dec;12(6):585-90. doi: 10.1016/j.jaapos.2008.06.005. Epub 2008 Oct 10.

Adjustable suture strabismus surgery in infants and children.

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  • 1The Krieger Children's Eye Center at Wilmer Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.



To evaluate the success rate of adjustable suture techniques in horizontal eye muscle surgery in children aged 10 years and younger.


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.


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(Delta) 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.


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.

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