Adjustable versus non-adjustable sutures for the eye muscles in strabismus surgery

Strabismus occurs when the eye deviates from its normally perfect alignment, and can be corrected with surgery. A variety of surgical techniques are available, including the use of adjustable or non-adjustable sutures for the muscles surrounding the eye. There is uncertainty as to which of these suture techniques results in a more accurate alignment of the eye, and whether there are specific situations in which it is of benefit to use a particular technique. This review could not find enough evidence to answer these questions and suggests that more research is needed. The review authors used existing evidence to propose that future randomised controlled trials should directly compare the adjustable to the non-adjustable suture technique, in co-operative patients with any type of strabismus. Trials should have a minimum of six months follow-up and should include important outcome measures such as re-operation rates, accuracy of ocular alignment, complications, economics and patient satisfaction. The information generated from well-designed studies could support a change in the conventional surgical management of strabismus and help to direct planning of surgical training.