title: Releasable conjunctival suture for adjustable suture surgery.
abstract: Adjustable sutures are widely used in adult strabismus surgery, with a second procedure performed to close the conjunctiva irrespective of whether adjustment is required. We describe a technique where the conjunctiva is closed using a buried releasable suture, eliminating the second procedure if adjustment is deemed unnecessary.
  
  
  
  The conjunctiva is closed using a 6/0 absorbable polyglactin 910 releasable suture. It is tied in a bow, like the muscle sutures, and tucked under the conjunctiva. If adjustment is not required, the eye does not need to be touched because the conjunctiva is secured by the suture. If adjustment is required, it is easy to untie the conjunctival suture, allowing good exposure to the underlying muscle sutures.
  
  
  
  In our prospective series of 30 patients, we found our technique effective and patient friendly. Patients had at least 3 months of follow-up with no significant complications.
  
  
  
  This technique is acceptable, accessible, and time saving for both surgeons and patients. It is especially useful for anxious patients and adolescents, for whom postoperative manipulation can be difficult, and for cases where the probability of adjustment is low.
authors.affiliation: Department of Ophthalmology Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Dan Q
authors.initials: DQ
authors.lastname: Nguyen
authors.forename: Julia
authors.initials: J
authors.lastname: Hale
authors.forename: Hirut
authors.initials: H
authors.lastname: Von Lany
authors.forename: Richard A
authors.initials: RA
authors.lastname: Harrad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011098:Polyglactin 910; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D011098:Polyglactin 910