Role of suture in securing extraocular muscles in strabismus surgery

This is Dr. Mark Silverberg for the Medical News Minute.

What are the critical factors when assessing suturing of extraocular muscles to the sclera?

Published online in JAAPOS, a laboratory analysis looks at an assessment of 6-0 Vicryl strength, number of knots placed, effects of damage on suture strength, and the role of the scleral tunnel.

The conclusions?

6-0 Vicryl has adequate tensile strength unless damaged by needle holders or a suture needle.

Knot strength is not increased by adding a fourth knot, but a fourth knot may provide resistance to suture slippage.

Frictional forces of the scleral tunnel are not adequate to provide muscle stabilization.