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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Virtual Ophthalmic Research Center
2022
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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 |
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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 |
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