Adjustable versus non-adjustable sutures for strabismus

Abstract

Strabismus, or squint, can be defined as a deviation from perfect ocular alignment and can be classified in many ways according to its aetiology and presentation. Treatment can be broadly divided into medical and surgical options, with a variety of surgical techniques being available, including the use of adjustable or non-adjustable sutures for the extra ocular muscles. There exists an uncertainty as to which of these techniques produces a better surgical outcome, and also an opinion that the adjustable suture technique may be of greater benefit in certain situations. The objectives of this review were to examine whether adjustable or non-adjustable sutures are associated with a more accurate long-term ocular alignment following strabismus surgery and to identify any specific situations in which it would be of benefit to use a particular method. We searched the Cochrane Central Register of Controlled Trials - CENTRAL on The Cochrane Library (which includes the Cochrane Eyes and Vision Group Trials Register) (Issue 3 2004), MEDLINE (1966 to July 2004), EMBASE (1980 to August 2004), LILACS (Latin American and Caribbean Literature on Health Sciences) (July 2004). We contacted experts in the field for further information. There were no language restrictions in the electronic searches. We planned to include only randomised controlled trials comparing adjustable to non-adjustable sutures for strabismus surgery. No studies were found that met the inclusion criteria for this review. No studies were found that met the inclusion criteria for this review, therefore none were included for analysis. Results of non-randomised studies that compared these techniques are reported. No reliable conclusions could be reached regarding which technique (adjustable or non-adjustable sutures) produces a more accurate long-term ocular alignment following strabismus surgery or in which specific situations one technique is of greater benefit than the other. High quality randomised controlled trials are needed to obtain clinically valid results and to clarify these issues.