Burton J Kushner1. 1. Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison 53705, USA. bkushner@facstaff.wisc.edu
Abstract
BACKGROUND: Muscle slippage is an adverse outcome of strabismus surgery. Its incidence is increased if adjustable sutures are used or if surgery is performed on the inferior or medial rectus muscles. Although there are no firm numbers for this complication, studies have suggested incidence rates between 7% and 41% when adjustable suture surgery is performed on the inferior rectus muscle. In theory, the semiadjustable suture procedure should decrease this adverse outcome. This procedure involves suturing the corners of the muscle firmly to the sclera and placing the center of the muscle on an adjustable suture. This study evaluates semiadjustable suture surgery with respect to muscle slippage. METHODS: The primary treatment group consisted of 57 patients who underwent semiadjustable suture surgery on a total of 61 muscles that either had never previously undergone surgery or had undergone surgery and had not previously slipped postoperatively. Fifty-five were inferior rectus muscles and 6 were medial rectus muscles. An additional 7 patients had semiadjustable suture surgery on muscles that had slipped after prior surgery and were analyzed separately. The outcome evaluation was at least 6 months after surgery. RESULTS: None of the 57 patients in the primary treatment group demonstrated muscle slippage after semiadjustable suture surgery. One of the 7 patients who had history of prior muscle slippage also had slippage after semiadjustable suture surgery. CONCLUSION: The semiadjustable suture procedure appears to decrease the incidence of muscle slippage.
BACKGROUND: Muscle slippage is an adverse outcome of strabismus surgery. Its incidence is increased if adjustable sutures are used or if surgery is performed on the inferior or medial rectus muscles. Although there are no firm numbers for this complication, studies have suggested incidence rates between 7% and 41% when adjustable suture surgery is performed on the inferior rectus muscle. In theory, the semiadjustable suture procedure should decrease this adverse outcome. This procedure involves suturing the corners of the muscle firmly to the sclera and placing the center of the muscle on an adjustable suture. This study evaluates semiadjustable suture surgery with respect to muscle slippage. METHODS: The primary treatment group consisted of 57 patients who underwent semiadjustable suture surgery on a total of 61 muscles that either had never previously undergone surgery or had undergone surgery and had not previously slipped postoperatively. Fifty-five were inferior rectus muscles and 6 were medial rectus muscles. An additional 7 patients had semiadjustable suture surgery on muscles that had slipped after prior surgery and were analyzed separately. The outcome evaluation was at least 6 months after surgery. RESULTS: None of the 57 patients in the primary treatment group demonstrated muscle slippage after semiadjustable suture surgery. One of the 7 patients who had history of prior muscle slippage also had slippage after semiadjustable suture surgery. CONCLUSION: The semiadjustable suture procedure appears to decrease the incidence of muscle slippage.
Authors: Christopher T Leffler; Kamyar Vaziri; Kara M Cavuoto; Craig A McKeown; Stephen G Schwartz; Krishna S Kishor; Allison Pariyadath Journal: Am J Ophthalmol Date: 2015-05-19 Impact factor: 5.258
Authors: Karen Hendler; Stacy L Pineles; Joseph L Demer; Arthur L Rosenbaum; Guillermo Velez; Federico G Velez Journal: Br J Ophthalmol Date: 2012-11-10 Impact factor: 4.638
Authors: Christopher T Leffler; Kamyar Vaziri; Stephen G Schwartz; Kara M Cavuoto; Craig A McKeown; Krishna S Kishor; Adam C Janot Journal: Am J Ophthalmol Date: 2015-11-05 Impact factor: 5.258