Cargando…

Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial

BACKGROUND: Adjustable sutures increase the success rate of strabismus surgery. However, the optimal timing of postoperative suture adjustment remains controversial. This trial was aimed at comparing the surgical outcomes and pain scores of early or 2 – 4 h and delayed or 24 h postoperative suture a...

Descripción completa

Detalles Bibliográficos
Autores principales: Abdelmonem, Ahmed Adel, Awadein, Ahmed, Genidy, Mahmoud Mohamed M, Abdelhalim, Ahmed Shawkat, Abdelaziz, Sahar Torky A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Virtual Ophthalmic Research Center 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460247/
https://www.ncbi.nlm.nih.gov/pubmed/37641609
http://dx.doi.org/10.51329/mehdiophthal1458
_version_ 1785097602248736768
author Abdelmonem, Ahmed Adel
Awadein, Ahmed
Genidy, Mahmoud Mohamed M
Abdelhalim, Ahmed Shawkat
Abdelaziz, Sahar Torky A
author_facet Abdelmonem, Ahmed Adel
Awadein, Ahmed
Genidy, Mahmoud Mohamed M
Abdelhalim, Ahmed Shawkat
Abdelaziz, Sahar Torky A
author_sort Abdelmonem, Ahmed Adel
collection PubMed
description BACKGROUND: Adjustable sutures increase the success rate of strabismus surgery. However, the optimal timing of postoperative suture adjustment remains controversial. This trial was aimed at comparing the surgical outcomes and pain scores of early or 2 – 4 h and delayed or 24 h postoperative suture adjustment in adult patients undergoing strabismus surgery. METHODS: An open-label, prospective, randomized, comparative interventional study was performed in consecutive adult patients scheduled for eye muscle surgery. Patients were randomized into two groups: the early group, with suture adjustment 2 – 4 h postoperatively, and the delayed group, with suture adjustment 24 h postoperatively. Subjective pain scores during the adjustment were also analyzed. The angles of misalignment at 1 and 3 months and the success rate at 3 months postoperatively were compared. RESULTS: Forty-five (90%) patients completed the follow-up, including 23 (92%) in the early adjustment group and 22 (88%) in the delayed adjustment group, with a mean (standard deviation) age of 25.6 (9.5) years and a male-to-female ratio of 46.7:53.3. Thirty patients (66.7%) had exotropia, and 15 (33.3%) patients had esotropia. Both groups had comparable baseline characteristics (all P > 0.05). The mean pain scores during adjustment did not differ significantly between groups (P > 0.05). The postoperative angles of alignment were comparable between the groups before suture adjustment and at the 1- and 3-month follow-ups (all P > 0.05). The success rate in the early adjustment group was slightly higher (87.0% versus 63.6%), but the difference was not statistically significant (P > 0.05). The success rate was comparable between the groups in patients with esotropia or exotropia (both P > 0.05). CONCLUSIONS: Although the early adjustment group had a slightly higher success rate, the difference was not significant. Both groups had comparable subjective pain scores during adjustment, final motor alignment, or success rate. Future clinical trials should be performed different time intervals for postoperative suture adjustment, and subjective and objective outcomes, such as diplopia and stereopsis, should be compared between patients with a first strabismus surgery and those who underwent reoperation. This could better resolve the persistent controversy related to the optimal time for suture adjustment.
format Online
Article
Text
id pubmed-10460247
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher International Virtual Ophthalmic Research Center
record_format MEDLINE/PubMed
spelling pubmed-104602472023-08-28 Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial Abdelmonem, Ahmed Adel Awadein, Ahmed Genidy, Mahmoud Mohamed M Abdelhalim, Ahmed Shawkat Abdelaziz, Sahar Torky A Med Hypothesis Discov Innov Ophthalmol Original Article BACKGROUND: Adjustable sutures increase the success rate of strabismus surgery. However, the optimal timing of postoperative suture adjustment remains controversial. This trial was aimed at comparing the surgical outcomes and pain scores of early or 2 – 4 h and delayed or 24 h postoperative suture adjustment in adult patients undergoing strabismus surgery. METHODS: An open-label, prospective, randomized, comparative interventional study was performed in consecutive adult patients scheduled for eye muscle surgery. Patients were randomized into two groups: the early group, with suture adjustment 2 – 4 h postoperatively, and the delayed group, with suture adjustment 24 h postoperatively. Subjective pain scores during the adjustment were also analyzed. The angles of misalignment at 1 and 3 months and the success rate at 3 months postoperatively were compared. RESULTS: Forty-five (90%) patients completed the follow-up, including 23 (92%) in the early adjustment group and 22 (88%) in the delayed adjustment group, with a mean (standard deviation) age of 25.6 (9.5) years and a male-to-female ratio of 46.7:53.3. Thirty patients (66.7%) had exotropia, and 15 (33.3%) patients had esotropia. Both groups had comparable baseline characteristics (all P > 0.05). The mean pain scores during adjustment did not differ significantly between groups (P > 0.05). The postoperative angles of alignment were comparable between the groups before suture adjustment and at the 1- and 3-month follow-ups (all P > 0.05). The success rate in the early adjustment group was slightly higher (87.0% versus 63.6%), but the difference was not statistically significant (P > 0.05). The success rate was comparable between the groups in patients with esotropia or exotropia (both P > 0.05). CONCLUSIONS: Although the early adjustment group had a slightly higher success rate, the difference was not significant. Both groups had comparable subjective pain scores during adjustment, final motor alignment, or success rate. Future clinical trials should be performed different time intervals for postoperative suture adjustment, and subjective and objective outcomes, such as diplopia and stereopsis, should be compared between patients with a first strabismus surgery and those who underwent reoperation. This could better resolve the persistent controversy related to the optimal time for suture adjustment. International Virtual Ophthalmic Research Center 2022-02-03 /pmc/articles/PMC10460247/ /pubmed/37641609 http://dx.doi.org/10.51329/mehdiophthal1458 Text en © Author(s). https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Original Article
Abdelmonem, Ahmed Adel
Awadein, Ahmed
Genidy, Mahmoud Mohamed M
Abdelhalim, Ahmed Shawkat
Abdelaziz, Sahar Torky A
Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
title Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
title_full Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
title_fullStr Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
title_full_unstemmed Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
title_short Early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
title_sort early and delayed suture adjustments after adjustable suture strabismus surgery: a randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460247/
https://www.ncbi.nlm.nih.gov/pubmed/37641609
http://dx.doi.org/10.51329/mehdiophthal1458
work_keys_str_mv AT abdelmonemahmedadel earlyanddelayedsutureadjustmentsafteradjustablesuturestrabismussurgeryarandomizedcontrolledtrial
AT awadeinahmed earlyanddelayedsutureadjustmentsafteradjustablesuturestrabismussurgeryarandomizedcontrolledtrial
AT genidymahmoudmohamedm earlyanddelayedsutureadjustmentsafteradjustablesuturestrabismussurgeryarandomizedcontrolledtrial
AT abdelhalimahmedshawkat earlyanddelayedsutureadjustmentsafteradjustablesuturestrabismussurgeryarandomizedcontrolledtrial
AT abdelazizsahartorkya earlyanddelayedsutureadjustmentsafteradjustablesuturestrabismussurgeryarandomizedcontrolledtrial