Postoperative results of absorbable, subconjunctival adjustable sutures

Abstract

Background Adjustable sutures have improved our ability to treat patients with strabismus. Inherent with its use, however, is the postoperative chore of dealing with the exposed sutures necessitating intervention in all patients. We describe a new surgical technique that utilizes a fornix incision in which absorbable sutures are placed in the subconjunctival space. Methods We conducted a retrospective review of patients in which this technique was utilized. Thirty patients were identified. Results Twenty-one patients required postoperative manipulation; ten were aligned in the postoperative recovery area in the period prior to discharge and eight in an office setting between days 1 and 4 postoperatively. Three patients were adjusted at both times. The patients adjusted in the immediate postoperative period experienced slightly less discomfort. Twenty-seven of the 30 patients (90%) had successful surgical outcome. Postoperative complications included more tissue response than is normally seen: four patients had a suture granuloma and two patients had a subconjunctival infection postoperatively. Conclusion The use of absorbable subconjunctival sutures in strabismus surgery reduces the need for postoperative manipulation in some patients and allows for delayed adjustment in other patients.