Is presoaking suture material prior to strabismus surgery appropriate?

Dr. Nelson has no financial or proprietary interest in the materials presented herein. doi: 10.3928/01913913-20120523-01 The incidence of perioperative inflammation after strabismus surgery is uncommon. Many of these cases may be related to when there is prolongation of the suture material dissolving, creating conjunctival injection around the suture. This phenomenon is more common in adult strabismus surgery patients. The incidence of endophthalmitis after strabismus surgery is extremely rare; in this issue, Eustis and Rhodes estimate it as 1 in 35,000 to 1 in 185,000 cases following strabismus surgery. These authors noted that in a prospective randomized analysis that the contamination rate of suture material use in strabismus surgery was least when the suture was pre-soaked with antiseptic and antibiotic/steroid combination compared to sutures without pretreatment or soaked just with antibiotic/steroid combination. Unfortunately, the authors did not identify the pathogen contaminating the sutures. Many of the pathogens were most likely normal flora. Because the incidence of endophthalmitis following strabismus surgery is rare and no specific pathogens were identified in Eustis and Rhodes’ study, further prospective studies may help to determine whether presoaking sutures prior to strabismus surgery are appropriate.