The effect of adjustable suture techniques on scleral resistance.
OBJECTIVE
The effect of adjustable suture strabismus surgery techniques on the ease of the postoperative adjustment has not been determined. An in vitro animal model was developed to compare several intraoperative variables with the ability to adjust the sutures.


METHODS
The amount of force required to advance and recess the suture was measured using different sutures, suture coatings, needles, and scleral tunnel techniques.


RESULTS
Scleral tunnels placed at an angle to the muscle insertion caused significantly greater scleral resistance as compared with tunnels placed perpendicular to the insertion. Although differences were noted in the scleral resistance with different needles, suture coatings, and suture materials, there was a considerable overlap of the effect.


CONCLUSIONS
Scleral tunnels placed perpendicular to the muscle insertion and parallel to the plane of action of the muscle offer the best technique for minimizing scleral resistance. Other less important factors include shorter scleral tunnels, larger needles, and special suture coatings.
Keech
R V
RV
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City 52242-1091, USA.
D000818:Animals; D006801:Humans; D009339:Needles; D009801:Oculomotor Muscles / Q000601:surgery; D011098:Polyglactin 910; D011182:Postoperative Care; D012590:Sclera / Q000601:surgery*; D013285:Strabismus / Q000601:surgery; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures; D013552:Swine
D011098:Polyglactin 910