Purpose Adjustable suture technique (AST) has been shown to be an effective
treatment method in adult strabismus. The application of AST is not well s
tudied in children due to potential poor cooperation during adjustment and
the concern that the adjustment process can not be completed. The present s
eries evaluates the efficacy and safety of this technique in a preselected
group of children between 7 and 15 years of age.
Methods A retrospective review of 89 consecutive children undergoing AST wa
s completed to assess: (1) the ability to perform and complete adjustment i
n children; (2) the frequency of need to perform adjustment; and (3) accura
cy of surgical alignment. Only patients with horizontal rectus muscle surge
ry were included.
Results All children successfully completed the AST on the first post-opera
tive day. Of the 89 patients, 24 (27%) required further adjustment by the A
ST. The mean follow-up period was 13.1 months. Fifty-three patients (60%) h
ad previous strabismus surgery (range 1 to 5 operations). Sixty-six (74%) p
atients achieved successful alignment. Complications included slipped muscl
es in 1 case and difficulty in recession of the lateral rectus muscle in 1
patient.
Conclusions Twenty-seven per cent of the patients required post-operative a
djustment. The AST achieved an overall 74% successful alignment. Applicatio
n of the AST should be considered in children with horizontal deviations ov
er age 7 years, especially in the reoperations of esotropia.