To Compare Long-Term Follow-Up Adjustable and Non-Adjustable Surgery Success Rates in Horizontal Strabismus Surgery

Yoon Jung Choy; Sung Eun Park

doi:10.3341/jkos.2012.53.2.316

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Choy and Park: To Compare Long-Term Follow-Up Adjustable and Non-Adjustable Surgery Success Rates in Horizontal Strabismus Surgery

Original Article

Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(2): 316-322.

Published online: 15 February 2012

DOI: https://doi.org/10.3341/jkos.2012.53.2.316

To Compare Long-Term Follow-Up Adjustable and Non-Adjustable Surgery Success Rates in Horizontal Strabismus Surgery

Yoon Jung Choy, MD, Sung Eun Park, MD

Department of Ophthalmology, Eulji University School of Medicine, Seoul, Korea.

Address reprint requests to Sung Eun Park, MD. Department of Ophthalmology, Eulji General Hospital, #14 Hangeulbiseok-gil, Nowon-gu, Seoul 139-872, Korea. Tel: 82-2-970-8271, Fax: 82-2-970-8272, se1106@hanmail.net

Received 21 March 2011 Accepted 13 December 2011

Abstract

Purpose

To compare the long-term follow-up surgical success rate of adjustable and non-adjustable surgery in horizontal strabismus.

Methods

A retrospective analysis was performed. The patients aged 15 years or older who were diagnosed with horizontal strabismus between September 2004 and August 2007 and who underwent at least 6 months of follow-up after surgery were reviewed. Eleven patients (Group A) underwent adjustable surgery, and 20 patients (Group B) underwent non-adjustable surgery. The surgical success rate of 31 patients with 6 months of follow-up were compared. After 2 years, the long-term follow-up surgical success rates of 10 patients in Group A and 12 patients in Group B were compared. Additionally, the changes between deviation angle on postoperative day 1 and final follow-up were compared.

Results

The success rates 6 months after surgery was 81.8% in Group A and 85.0% in Group B, a difference that was not statistically significant (p = 0.82). The success rate over 2 years of follow-up after surgery was 80.0% in Group A and 58.3% in Group B, and the difference was not statistically significant (p = 0.28). However, the change in deviation angle was more stable in Group A than in Group B, and standard deviation, skewness, and kurtosis were lower in Group A.

Conclusions

After 2 years of follow-up, the success rate of adjustable surgery was higher than the non-adjustable surgery (Group A 80%, Group B 58.3%, p = 0.28). Moreover, in adjustable surgery, the changes in deviation angle were smaller and more stable.

Keywords: Adjustable surgery, Non-adjustable surgery, Success rate

Figures and Tables

Figure 1

Procedures of adjustable rectus muscle recession. (A) Sutures are passed through the each end of original insertion and passed through center of original insertion again. (B) A slipknot is tied around the sutures to hold the muscle at the desired distance for a hangback recession.

Table 1

Clinical data of Group A and Group B

Values are presented as mean ± SD or number (%).

^*Mann-Whitney U-test; ^†Chi-square test.

Table 2

Success rate of Group A and Group B at postoperative 6 months

Values are presented as % (n).

^*Chi-square test.

Table 3

Levels of significance of preoperative factors to surgical success rate of two groups at postoperative 6 months

Values are presented as % (n).

^*Chi-square test.

Table 4

Preoperative deviation angles and postoperative change of deviation angle in two groups

^*Last follow-up prism diopters minus non-adjustable surgery.

Table 5

Long-term follow-up success rate of Group A and Group B beyond 2 years after operation

Values are presented as % (n).

^*Chi-square test.

Table 6

Statistical analysis of change of deviation angle

^*Descriptive statistics.

References

1. Kang NY, Kwon JY, Kim MM, et al. Current Concepts in Strabismus. 2008. 2nd ed. Seoul: Korean Association for Pediatric Ophthalmology and Strabismus;452–454.

2. Kim DS, Lee SK. The effect of intraoperative adjustable suture strabismus surgery in adult strabismus patients. J Korean Ophthalmol Soc. 1997. 38:2056–2063.

3. Chow PC. Stability of one-stage adjustable suture for the correction of horizontal strabismus. Br J Ophthalmol. 1989. 73:541–546.

4. Yi JH, Chung SA, Chang YH, Lee JB. Practical aspects and efficacy of intraoperative adjustment in concomitant horizontal strabismus surgery. J Pediatr Ophthalmol Strabismus. 2011. 48:85–89.

5. Tripathi A, Haslett R, Marsh IB. Strabismus surgery: adjustable sutures-good for all? Eye (Lond). 2003. 17:739–742.

6. Ogüt MS, Onal S, Demirtas S. Adjustable suture surgery for correction of various types of strabismus. Ophthalmic Surg Lasers Imaging. 2007. 38:196–202.

7. Park YC, Chun BY, Kwon JY. Comparison of the stability of postoperative alignment in sensory exotropia: adjustable versus non-adjustable surgery. Korean J Ophthalmol. 2009. 23:277–280.

8. Kraft SP, Jacobson ME. Techniques of adjustable suture strabismus surgery. Ophthalmic Surg. 1990. 21:633–640.

9. Lueder GT, Scott WE, Kutschke PJ, Keech RV. Long-term results of adjustable suture surgery for strabismus secondary to thyroid ophthalmopathy. Ophthalmology. 1992. 99:993–997.

10. Park HY, Jung SK, Nam KR. Surgical results of adjustable strabismus surgery in horizontal rectus muscles. J Korean Ophthalmol Soc. 1996. 37:1335–1341.

11. Buffenn AN. Adjustable suture use in strabismus surgery. Curr Opin Ophthalmol. 2005. 16:294–297.

12. Scott WE, Martin-Casals A, Jackson OB. Adjustable sutures in strabismus surgery. J Pediatr Ophthalmol. 1977. 14:71–75.

13. Budning AS, Day C, Nguyen A. The short adjustable suture. Can J Ophthalmol. 2010. 45:359–362.

14. Jampolsky A. Strabismus reoperation techniques. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1975. 79:704–717.

15. Keech RV, Scott WE, Christensen LE. Adjustable suture strabismus surgery. J Pediatr Ophthalmol Strabismus. 1987. 24:97–102.

16. Weston B, Enzenauer RW, Kraft SP, Gayowsky GR. Stability of the postoperative alignment in adjustable-suture strabismus surgery. J Pediatr Ophthalmol Strabismus. 1991. 28:206–211.

17. Wisnicki HJ, Repka MX, Guyton DL. Reoperation rate in adjustable strabismus surgery. J Pediatr Ophthalmol Strabismus. 1988. 25:112–114.

18. George ND. Adjustable sutures: who needs them? Eye (Lond). 2003. 17:683–684.

19. Metz HS. Adjustable suture strabismus surgery. Ann Ophthalmol. 1979. 11:1593–1597.

20. Eino D, Kraft SP. Postoperative drifts after adjustable-suture strabismus surgery. Can J Ophthalmol. 1997. 32:163–169.

21. Rosenbaum AL, Metz HS, Carlson M, Jampolsky AJ. Adjustable rectus muscle recession surgery. A follow-up study. Arch Ophthalmol. 1977. 95:817–820.

22. Melhuish JA, Kemp EG. The routine use of adjustable sutures in adult strabismus surgery. J R Coll Surg Edinb. 1993. 38:134–137.

23. Rauz S, Govan JA. One stage vertical rectus muscle recession using adjustable sutures under local anaesthesia. Br J Ophthalmol. 1996. 80:713–718.

24. Kim IT, Cho SH, Park MR, Park SC. Adjustable strabismus surgery under intravenous anesthesia with propofol and fentanyl. J Korean Ophthalmol Soc. 2007. 48:1522–1526.

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