title: Timing of postoperative adjustment in adjustable suture strabismus surgery.
abstract: OBJECTIVE
  The use of adjustable sutures in strabismus surgery has increased the rate of surgical success. Little data are available on the optimum timing for postoperative adjustment after strabismus surgery. We wanted to compare 2 common practices of adjustable suture technique after strabismus surgery.
  
  
  METHODS
  Two comparable groups of 40 patients each, who had strabismus surgery with adjustable suture technique, were prospectively studied. Group A had early adjustment the same day of the surgery about 6 hours after the operation, and group B had late adjustment the next day about 24 hours after the operation. Subjective scoring tables were used to evaluate the pain felt by the patient before, during, and after the adjustment and any difficulties of the adjustment process. Requirements of postoperative pain medications and final alignment 6 weeks after surgery were also compared.
  
  
  RESULTS
  Despite adequate statistical power, no significant differences were found between the groups regarding pain before, during, and after adjustment, difficulties performing the adjustment, and final alignment after 6 weeks (P > .05). Both adjustment schedules were equally associated with mild to moderate pain before, during, and after the adjustment. In the first 24 hours after surgery, no overall difference in the use of pain medications was found. Nausea and vomiting in the first 24 postoperative hours were more common in the early adjustment group (P = .02).
  
  
  CONCLUSIONS
  The surgeon can feel free to choose the timing for postoperative adjustment. However, when performing an early adjustment, the surgeon should be especially prepared to control nausea and vomiting.
authors.affiliation: Department of Ophthalmology and Anesthesiology, University of California, Los Angeles, California 90095, USA.
authors.forename: F G
authors.initials: FG
authors.lastname: Velez
authors.forename: T K
authors.initials: TK
authors.lastname: Chan
authors.forename: T
authors.initials: T
authors.lastname: Vives
authors.forename: T
authors.initials: T
authors.lastname: Chou
authors.forename: R A
authors.initials: RA
authors.lastname: Clark
authors.forename: M
authors.initials: M
authors.lastname: Keyes
authors.forename: A L
authors.initials: AL
authors.lastname: Rosenbaum
authors.forename: S J
authors.initials: SJ
authors.lastname: Isenberg
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000517:prevention & control; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D011098:Polyglactin 910; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures; D013997:Time Factors; D015348:Vision, Binocular; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control
chemical_list: D011098:Polyglactin 910