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Drift of ocular alignment following strabismus surgery. Part 2: using adjustable sutures
  1. S J Isenberg1,
  2. P Abdarbashi2
  1. 1
    Jules Stein Eye Institute/UCLA Medical Center, UCLA David Geffen School of Medicine, Los Angeles, California, USA
  2. 2
    Ross University School of Medicine, Edison, New Jersey, USA
  1. Dr S J Isenberg, Jules Stein Eye Institute, Department of Ophthalmology, UCLA Medical Center, 100 Stein Plaza, UCLA, Los Angeles, CA 90095, USA; isenberg{at}


Aim: To measure the drift of ocular alignment following strabismus surgery utilising adjustable sutures.

Methods: 106 patients, aged 12 to 84 years, underwent adjustable suture strabismus surgery with a follow-up of 0.5–4 years (mean 24.3 months).

Results: For all subjects measured on distant fixation, there was a mean undercorrection drift of 8.3 (SD 2.3) prism dioptres (PD) from week 1 to 48 months postoperatively (p = 0.005). Patients with exotropia demonstrated an undercorrection drift on distant fixation from week 1 to 2 years (mean 10.1 (3.5) PD, p = 0.023). Patients who underwent recession surgery developed a mean 9.1 (3.3) PD undercorrection drift from week 1 to 3 years (p = 0.031). Patients who had unilateral recession and resection surgery showed a mean 6.8 (2.9) PD undercorrection drift from week 1 to 18 months (p = 0.049). Patients with constant or intermittent postoperative stereopsis had a statistically significant undercorrection drift (⩽5.1 PD) at certain postoperative periods (p<0.042), while those without stereopsis had no significant drift.

Conclusion: Most patients developed a general drift toward undercorrection, especially following recession or recession with resection surgery and those with exotropia. Surgeons should consider creating a mild overcorrection at the time of suture adjustment, while avoiding long-term diplopia.

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  • See Editorial, p 419

  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by the Institution Review Board of the Office for Protection of Research Subjects of UCLA.

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