Adjustment of sutures 8 hours vs 24 hours after strabismus surgery

PURPOSE: To compare the postoperative results of adjustable-suture strabism us surgery when suture adjustment was performed 8 hours (group 1) and 24 ho urs (group 2) after surgery. METHODS: A retrospective clinical study was conducted in two hospitals. Str abismus surgery and muscle adjustment were performed in 90 patients. All pa tients had horizontal strabismus (40 patients had esotropia and 50 patients had exotropia), and they underwent either primary surgery or reoperation. Mean age of the patients was 29.9 +/- 14.1 (range, 14 to 74) years. The ang le of deviation was measured in all patients before surgery, after surgery both before and after adjustment, and at the final follow-up examination. T he follow-up period was 6 to 40 months (mean, 19.6 months). RESULTS: Preoperative data were similar in the two groups. The mean angle o f deviation immediately after muscle adjustment was 0.6 +/- 6.1 prism diopt ers in group 1 and 0.4 +/- 6.3 prism diopters in group 2, This similar devi ation in the two groups (P = .9) changed during the follow-up period, and a t the final examination the measured angles in groups 1 and 2 were -1.0 +/- 7.9 and -2.5 +/- 10.3 prism diopters, respectively (P = .48). The most con siderable outcome measure was the calculated drift values, At the last foll ow-up these values were -1.6 +/- 5.8 for group 1 and -2.9 +/- 11 prism diop ters for group 2 (P = .5). Subdividing the patients on the basis of their d eviation before surgery, a postoperative drift toward exotropia was found i n most patients of group 1. In group 2, however, a greater tendency toward exotropia was shown only by those patients who had displayed exotropia preo peratively, whereas patients with preoperative esotropia showed a greater t endency toward esotropia after surgery. CONCLUSION: In patients undergoing horizontal extraocular muscle surgery wi th adjustable sutures, suture adjustment 8 hours or 24 hours after surgery did not produce significantly different results. (Am J Ophthalmol 2000;129: 521-524. (C) 2000 by Elsevier Science Inc.:All rights reserved.).