The results of adjustable suture technique in paediatric strabismus surgery

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.