Early versus delayed suture adjustments in strabismus surgery
Research type
Research Study
Full title
Early versus delayed suture adjustments in strabismus surgery
IRAS ID
342577
Contact name
Saurabh Jain
Contact email
Sponsor organisation
Royal Free London NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Currently, when an individual undergoes squint surgery to realign their eyes, one eye muscle is left on an adjustable stitch. The position of the eyes is then measured and adjusted when the patient wakes up after the operation. By being able to adjust the muscle position, the surgeon may be able to maximise the probability of successful eye alignment. Clinical experience shows that patients are often sleepy and disorientated from anaesthesia during surgery and individuals vary in time of recovery for this. We believe that measurements of the deviation and adjustments may be better the day after surgery when patients are more awake, and alert and the brain has had a chance to adjust to the new position of their eyes.
While robust evidence supports the favourable effect and tolerability of this technique, the exact optimal timing for suture adjustment remains contentious, ranging from 2 hours to 14 days postoperatively. Our current practice is to leave one muscle on an adjustable stitch to measure and adjust the position of the eyes when they wake up after the operation. We postulate that the eye position would be better aligned the day following the surgery when patients are more awake and the brain has had a chance to process images from binocular vision.
Our aim is to compare two cohorts of patients with approximately 25 in each. Patients will be identified at pre-operative clinic appointments and randomised to either undergoing the standard of care (i.e. having their suture adjusted on the day of surgery, usually around 1 hour post operatively) or having their suture adjusted the next day (i.e. 24 hours after surgery). Patients will be be followed up at 4 weeks and 3 months post-op. We will collect data on the angle of deviation pre- post surgery and pain scores (determined by questionnaire).
REC name
South West - Frenchay Research Ethics Committee
REC reference
26/SW/0018
Date of REC Opinion
16 Apr 2026
REC opinion
Further Information Favourable Opinion