Adjustable suture strabismus surgery.
Summary of "Adjustable suture strabismus surgery."
Surgical management of strabismus remains a challenge because surgical success rates, short-term and long-term, are not ideal. Adjustable suture strabismus surgery has been available for decades as a tool to potentially enhance the surgical outcomes. Intellectually, it seems logical that having a second chance to improve the outcome of a strabismus procedure should increase the overall success rate and reduce the reoperation rate. Yet, adjustable suture surgery has not gained universal acceptance, partly because Level 1 evidence of its advantages is lacking, and partly because the learning curve for accurate decision making during suture adjustment may span a decade or more. In this review we describe the indications, techniques, and published results of adjustable suture surgery. We will discuss the option of 'no adjustment' in cases with satisfactory alignment with emphasis on recent advances allowing for delayed adjustment. The use of adjustable sutures in special circumstances will also be reviewed. Consistently improved outcomes in the adjustable arm of nearly all retrospective studies support the advantage of the adjustable option, and strabismus surgeons are advised to become facile in the application of this approach.Eye advance online publication, 15 July 2011; doi:10.1038/eye.2011.167.
Affiliation
Department of Ophthalmology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.
Journal Details
This article was published in the following journal.
Name: Eye (London, England)
ISSN: 1476-5454
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21760626
- DOI: http://dx.doi.org/10.1038/eye.2011.167
Medical and Biotech [MESH] Definitions
Suture Anchors
Implants used in arthroscopic surgery and other orthopedic procedures to attach soft tissue to bone. One end of a suture is tied to soft tissue and the other end to the implant. The anchors are made of a variety of materials including titanium, stainless steel, or absorbable polymers.
Strabismus
Misalignment of the visual axes of the eyes. In comitant strabismus the degree of ocular misalignment does not vary with the direction of gaze. In noncomitant strabismus the degree of misalignment varies depending on direction of gaze or which eye is fixating on the target. (Miller, Walsh & Hoyt's Clinical Neuro-Ophthalmology, 4th ed, p641)
Surgery, Computer-assisted
Surgical procedures conducted with the aid of computers. This is most frequently used in orthopedic and laparoscopic surgery for implant placement and instrument guidance. Image-guided surgery interactively combines prior CT scans or MRI images with real-time video.
Polyglycolic Acid
A biocompatible polymer used as a surgical suture material.
Cerclage, Cervical
The surgical closure of the incompetent cervix uteri with suture material.
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