Short Loop Modification of the Semiadjustable Suture Strabismus Procedure for Optional Adjustment

Abstract

ABSTRACT Purpose To present a modification of the semiadjustable suture technique allowing for optional adjustment. Methods Short suture loops buried under closed conjunctiva were used instead of the exposed long muscle and sliding noose sutures involved in the standard semiadjustable suture procedure; an additional temporary tracing suture facilitated the retrieval of the buried muscle suture loop during adjustment. Results Fifty-three consecutive patients (57 rectus extraocular muscles) underwent recession with the modified semiadjustable short loop technique. The mean age was 44.5 years (range: 16–81) and mean follow-up time 8.8 months (range 1.5–28 months). Postoperative adjustment was carried out in 21 patients (39.6%). In the remaining 32 patients, cutting and removing the exposed tracing suture and the nonabsorbable traction suture was the only necessary postoperative maneuver. Five cases of persistent conjunctival hyperemia, two cases of conjunctival dehiscence and two cases with a clinically significant delle were noted; all responded to topical treatment. There were no cases of suspected muscle slippage. Conclusions The short loop modification of the semiadjustable suture procedure allowed for postoperative adjustment while offering the benefit of minimal manipulation for the majority of cases in which adjustment was unnecessary. No major complications in conjunctival incision or extraocular muscle healing were encountered.