Accuracy of suture adjustment in adjustable strabismus surgery evaluated at the initial postoperative examination.

PURPOSE To clarify the efficacy of sliding-noose type adjustable suture strabismus surgery, we evaluated the accuracy of suture adjustment based on data from the initial postoperative examination performed 1-4 weeks after the surgery. METHODS Thirty-four patients with various types of strabismus participated [age range, 12-79 years; range of far deviation, 4-123 prism diopters (PD)]. Under sub-Tenon anesthesia, a recession (with or without a resection or muscle transposition) was performed with an adjustable suture (Guyton's procedure), and the suture was adjusted 6-24 hours after surgery. RESULTS Twenty-six (76%) patients required suture adjustment one to eight times. In 50% and 75% of our patients, the errors from individual target angle were within +/- 0.8 and +/- 2.0 PD, respectively, whereas 2 (6%) patients with esotropia showed an undercorrection larger than 10 PD. The error distribution was almost the same throughout the range of preoperative deviation. CONCLUSION By using an adjustable suture with a sliding noose, pinpoint alignment of the eyes can be achieved in more than half of the cases, at least in the early postoperative period.