Abstract
Objective
To evaluate the incidence of consecutive exotropia following bilateral medial rectus muscle recession surgery (BMR) for esotropia using non-absorbable compared with absorbable sutures in children undergoing strabismus surgery.
Methods
A retrospective cohort study of all children with esotropia who underwent BMR by a single surgeon in a tertiary public hospital. As of February 2018, only non-absorbable sutures were used. The primary outcome was the incidence of consecutive exotropia.
Results
A total of 121 children were included in the analysis, 3.66 ± 2.62 years, 53% were male. In 80 children (66%) non-absorbable sutures were used (non-absorbable group) and in 41 children (34%) absorbable sutures were used (absorbable group). Consecutive exotropia (≥ 8 prism dioptres) occurred in ten children (24%) in the absorbable group and in three children (4%) in the non-absorbable group (OR = 8.28, 95% CI = 2.13–32.13; P = 0.002). This difference between groups remained significant after adjustment for potential confounders and follow-up time (HR = 4.98, 95% CI = 1.30–19.05, P = 0.019). Mean follow-up time was 22 and 12 months in the absorbable and non-absorbable groups, respectively (P < 0.001). Two children in the non-absorbable group had pyogenic granuloma that resolved after 3 months of topical steroidal therapy.
Conclusion
Routine use of non-absorbable sutures in BMR surgery for esotropia may be a preferable alternative to absorbable sutures for the prevention of consecutive exotropia.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by BD-P, YM, AE-L, EP and MEH. The first draft of the manuscript was written by BD-P, YM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The study was approved by the Shamir Medical Centre Studies Institutional Review Board and adhered to the tenets of the declaration of Helsinki.
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Dubinsky-Pertzov, B., Einan-Lifshitz, A., Pras, E. et al. Routine use of non-absorbable sutures in bi-medial rectus recession as a measure to reduce the incidence of consecutive exotropia. Eye 36, 1772–1776 (2022). https://doi.org/10.1038/s41433-021-01724-6
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DOI: https://doi.org/10.1038/s41433-021-01724-6
