title: Strabismus Surgery Reoperation Rates With Adjustable and Conventional Sutures.
abstract: OBJECTIVE
  To determine the association of strabismus surgery reoperation rates with adjustable or conventional sutures.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  setting: Review of a large national private insurance database.
  
  
  METHODS
  Adults aged 18-89 having strabismus surgery between 2007 and 2011.
  
  
  METHODS
  Adjustable vs conventional suture strabismus surgery.
  
  
  METHODS
  Reoperation rate in the first postoperative year.
  
  
  RESULTS
  Overall, 526 of 6178 surgical patients had a reoperation (8.5%). Reoperations were performed after 8.1% of adjustable suture surgeries and after 8.6% of conventional suture surgeries (P = .57). Of the 4357 horizontal muscle surgeries, reoperations were performed after 5.8% of adjustable suture surgeries, and after 7.8% of conventional suture surgeries (P = .02). Of the 1072 vertical muscle surgeries, reoperations were performed after 15.2% of adjustable suture surgeries and after 10.4% of conventional suture surgeries (P = .05). Younger age (18-39 years) was associated with a lower reoperation rate (P ≤ .02). The significant multivariable predictors of reoperation for horizontal surgery were adjustable sutures (odds ratio [OR] 0.69, 95% confidence interval 0.52-0.91), monocular deviation (OR 0.64), complex surgery (OR 1.63), and unilateral surgery on 2 horizontal muscles (OR 0.70, all P ≤ .01). Adjustable sutures were not significantly associated with reoperation rates after vertical muscle surgery (multivariable OR 1.45, P = .07).
  
  
  CONCLUSIONS
  Adjustable sutures were associated with significantly fewer reoperations for horizontal muscle surgery. Adjustable sutures tended to be associated with more reoperations for vertical muscle surgery, but this observation was not statistically significant in the primary analysis after controlling for age.
authors.affiliation: Department of Ophthalmology, Virginia Commonwealth University Medical Center, Richmond, Virginia. Electronic address: chrislefflermd@gmail.com.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Leffler
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Vaziri
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Kara M
authors.initials: KM
authors.lastname: Cavuoto
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Craig A
authors.initials: CA
authors.lastname: McKeown
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Schwartz
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Krishna S
authors.initials: KS
authors.lastname: Kishor
authors.affiliation: Department of Ophthalmology, Virginia Commonwealth University Medical Center, Richmond, Virginia.
authors.forename: Allison
authors.initials: A
authors.lastname: Pariyadath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000706:statistics & numerical data*; D011184:Postoperative Period; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D055815:Young Adult