Our Summary

This study examined whether using an adjustable-suture technique in eye muscle surgery (strabismus surgery) could reduce the number of patients needing a second operation. The researchers looked at payment data for Medicare providers who performed these surgeries in 2012. They found that when the adjustable technique was used, fewer patients needed a second surgery. Specifically, for horizontal muscle surgery, 4.1% of patients needed a second operation when the adjustable technique was used, compared to 7.1% when it wasn’t. For vertical muscle surgery, the numbers were similar (4.1% vs 8.3%). However, the difference was only statistically significant for horizontal muscle surgery. The study also found that the number of surgeries a practice performed did not affect the reoperation rate. The results suggest that the adjustable-suture technique can reduce the need for further surgery in patients undergoing horizontal muscle surgery.

FAQs

  1. What is the adjustable-suture technique in strabismus surgery?
  2. How does the use of the adjustable technique impact the rate of a second surgery required?
  3. Did the study find a significant difference in reoperation rate between horizontal and vertical muscle surgeries using the adjustable-suture technique?

Doctor’s Tip

A doctor might tell a patient considering strabismus surgery that using an adjustable-suture technique can help reduce the likelihood of needing a second operation. This technique has been shown to be particularly effective for horizontal muscle surgery, with a lower reoperation rate compared to traditional methods. It is important to discuss this option with your surgeon to determine if it is the best choice for your specific case.

Suitable For

Patients who may be recommended strabismus surgery include those with:

  1. Strabismus that is not improving with other treatments such as glasses, vision therapy, or eye patching
  2. Strabismus that is causing significant visual impairment or double vision
  3. Strabismus that is affecting the alignment of the eyes and causing cosmetic concerns
  4. Children with strabismus that is impacting their development or ability to learn
  5. Adults with strabismus that is affecting their quality of life or ability to perform daily tasks

It is important for patients to undergo a comprehensive eye examination and evaluation by an ophthalmologist specializing in strabismus to determine if surgery is the best treatment option for their specific condition.

Timeline

Before strabismus surgery, a patient typically undergoes a comprehensive eye exam and consultation with an ophthalmologist to determine the severity of their condition and the best course of treatment. They may also undergo additional tests such as vision testing, imaging studies, and eye muscle function tests.

On the day of surgery, the patient will arrive at the surgical facility and undergo preoperative preparations, which may include administering anesthesia. During the surgery, the ophthalmologist will make small incisions in the eye muscles and adjust their position to correct the misalignment. The adjustable-suture technique involves using temporary sutures that can be adjusted during the surgery to fine-tune the alignment.

After the surgery, the patient will be monitored in a recovery area before being discharged home. They may experience temporary discomfort, redness, and swelling in the eye area. The ophthalmologist will provide postoperative instructions for care, including using prescribed eye drops, wearing an eye patch, and avoiding certain activities.

In the weeks and months following the surgery, the patient will attend follow-up appointments with the ophthalmologist to monitor their progress and ensure that the eye muscles are healing properly. Adjustments to the sutures may be made during these appointments to optimize the alignment. Overall, the goal of strabismus surgery is to improve the alignment of the eyes and enhance visual function for the patient.

What to Ask Your Doctor

  1. What is the success rate of strabismus surgery using the adjustable-suture technique compared to traditional techniques?
  2. What are the potential risks and complications associated with strabismus surgery?
  3. How long is the recovery period after strabismus surgery?
  4. Will I need to wear an eye patch or use eye drops after the surgery?
  5. How soon after the surgery will I notice an improvement in my eye alignment?
  6. Will I need to follow up with you for post-operative care and monitoring?
  7. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  8. How experienced are you in performing strabismus surgery, and how many of these procedures have you done in the past?
  9. Will I need to undergo general anesthesia for the surgery, or can it be done with local anesthesia?
  10. What is the likelihood that I will need a second surgery in the future, regardless of the technique used?

Reference

Authors: Leffler CT, Pariyadath A. Journal: Digit J Ophthalmol. 2016 Mar 15;22(1):6-11. doi: 10.5693/djo.01.2016.02.001. eCollection 2016. PMID: 27330477