A comparison of sutures for adjustable strabismus surgery

Background: The adjustable suture technique after strabismus surgery may be more easily performed if the sutures offered minimal resistance during the procedure as desired by the surgeon. Methods: In a rabbit model, 3 different types of 6-0 absorbable sutures—Biosorb-C (polyglycolic acid with polycaprolate coating, Alcon Surgical), coated Vicryl (polyglactin 910 coated with polyglactin 370 and calcium stearate, Ethicon), and Dexon-“S” (polyglycolic acid, Davis and Geck)—were advanced through scleral tunnels when attached and not attached to extraocular muscles. Resistance was measured with a precise strain gauge accurate to 0.1 g with an intrinsic microprocessor. Results: For unattached advancements, Biosorb-C offered significantly less resistance than Vicryl at 6 and 24 hours after operation (P < .02), whereas Dexon-“S” offered less resistance than Vicryl only at 24 hours (P = .001). At 6 hours, Biosorb-C sutures were marginally more slippery than Dexon-“S” (P = .07). For sutures attached to extraocular muscles at 6 hours after surgery, the 3 sutures offered similar resistance. By 24 hours after the initial procedure, Vicryl presented significantly more resistance than either Biosorb-C or Dexon-“S” (P < .01 for both). For all comparisons of 6 versus 24 hours after surgery, the only significant increase in resistance were Vicryl sutures attached to muscles (P = .02). Conclusions: These data support the use of Biosorb-C and Dexon-“S” for the adjustable suture technique whether adjusted at 6 or 24 hours after the initial procedure, although Biosorb-C may be slightly easier to adjust at 6 hours. If Vicryl is used, it would be easier to adjust the muscle 6 hours after surgery rather than after 24 hours. (J AAPOS 1999;3:91-3)