Adjustable Suture Strabismus Surgery in Children

Adjustable suture strabismus surgery is a well-established technique among adult strabismus surgeons. It is particularly valuable in complex cases and reoperations in which the use of fixed sutures can be unpredictable. The use of adjustable sutures in the pediatric population is far less common, even among strabismus surgeons who use adjustable sutures routinely in adults. Children are thought to be not cooperative enough for satisfactory assessment in the immediate postoperative period. Additionally, surgeons generally face resistance from anesthesia personnel and postanesthesia care unit (PACU) nursing teams because of the perceived complexity of the adjustment procedure in terms of cost, time, and stress on operating room (OR) and PACU resources.