Tying the knot. Is it always necessary?
R. A. Saunders and J. W. O'Neil
Department of Ophthalmology, Medical University of South Carolina, Storm Eye Institute, Charleston 29425-2236.
Securing the final muscle position during adjustable-suture strabismus
surgery is usually accomplished by tying the sutures in a knot in the early
postoperative period. Even patients who have satisfactory ocular alignment
without adjustment require manipulation of inflamed ocular tissues to
secure the muscle. In our experience, approximately half of these cases are
not adjusted. We have devised a technique in which postoperative knot tying
is required only in those patients who actually undergo adjustment. In our
series of 42 patients who underwent adjustable-suture surgery, 22 cases
were not adjusted and 30 cases were left untied. No instances of muscle
slippage occurred. We believe this reduction in postoperative manipulation
represents an improvement in adjustable-suture strabismus surgery.
