Adjusting The Nonadjustable Suture –A Reality‼

1. Mukesh Sharma
2. Mamta Sharma
3. Ankur Midha
4. Gaurav Bhati

S.M.S.Medical College, Jaipur ,India

Purpose: Adjustable suture squint surgery offers significant advantage in term of more predictable post operative results but it's use is limited by compulsory need of taking every patient to operative room second time which significantly adds to the cost and the agony . To eliminate this disadvantage we have designed a special suture pattern which allows adjustment in the virtually nonadjustable suture there by giving us the advantages of both the worlds

Methods: A prospective study of 25 cases with horizontal squint requiring surgery was conducted between January 2008- Dec 2009 .Exotropia was there in 14 while Esotropia was present in remaining 11. In 17 patients two muscles were operated while three muscles were operated in 5 & single muscle was operated in 3 patients .In all patients one muscle was recessed(hanged back) using a specially designed suture pattern in which leverage for knot removal and readjustment could be possible

Results: In our study post operative adjustment was needed in 7 out of 25 patients only for residual/ consecutive deviation , all these patients were taken to the operative room with in 24 hrs after surgery and suture adjustment was successfully done .

Conclusions: This specially designed suture gave us flexibility of readjustment in all patients ; simultaneously avoiding the compulsory need of taking every patient postoperatively to operative room to tie the adjustable suture (contemporary ) there by significantly reducing the cost as well as trauma to patient as well as surgeon in most cases.