ABSTRACT
Purpose: The objective of this study was to determine the associations of strabismus surgery reoperation rates in a large national database of provider payments with geographic region, practice type and volume, and the availability of adjustable suture technique. Methods: Fee-for-service payments to providers for medicare beneficiaries having strabismus surgery between 2012 and 2015 were retrospectively analyzed to identify reoperations in the same calendar year. The adjustable-suture technique was considered to be available to the patient if the patient's surgeon billed for adjustable sutures. Predictors of reoperation in the same calendar year were determined by multivariable logistic regression. Results: Availability of the adjustable suture technique was not associated with reoperation rate in multivariable analysis among 5971 patients having horizontal muscle surgery (odds ratio, [OR] 0.86, P = 0.29), 2840 patients having vertical muscle surgery (OR 0.98, P = 0.93), or 1199 patients having surgery with scarring or restriction (OR 0.86, P = 0.61). For horizontal surgery, the reoperation rate was higher in academic practices (OR 1.67), as compared with community practices, and in the South (OR 2.85) and West (OR 1.92, all P < 0.001). The reoperation rate was unchanged with surgeons in the lowest-quartile of surgical volume. Among surgeons paid for horizontal surgery, 45% of surgeons in the Northeast, the West, or Florida coded for adjustable sutures, compared with 8% of surgeons elsewhere (P < 0.001). Conclusion: The availability of the adjustable-suture technique was not associated with reoperation rate after strabismus surgery in this large national database. Having surgery by a lower-volume surgeon was not associated with a higher reoperation rate. The reoperation rate was higher when surgery was conducted in an academic practice, or in certain regions of the country. Adjustable sutures are largely a bicoastal practice.
ABSTRACT
Objective To evaluate the recent safety and long-term curative effect of double-pool shaping trabeculectomy with adjustable sutures in glaucoma. Methods A hundred and twenty patients with glaucoma were randomly divided into two groups, in which the control group in 62 patients underwent traditional trabeculectomy and the experimental group in 58 patients underwent double-pool shaping trabeculectomy with adjustable sutures. All patients were followed up for one year. Postoprative intraocular pressure, anterior chamber depth and filtering bleb were observed. Results In the experimental group, after the demolition of adjustable sutures, 3 eyes(5.17%) suffered from I degree shallow anterior chamber. By contrast, 8 eyes suffered from I degree shallow anterior chamber, and 1 eye (total 14.52%) suffered from Ⅱ degree shallow anterior chamber in the control group (P < 0.05). Following up in one year, the functional filtering bleb and intraocular pressure got better in the experimental group than in the control group (P < 0.05). Conclusion Double-pool shaping trabeculectomy with adjustable sutures is a safe and feasible method for glaucoma, in which it can effectively reduce intraocular pressure without complications.
ABSTRACT
AIM:To discuss the application effect of adjustable sutures in glaucoma filtering operation after trabecular resection. METHODS: Seventy-eight cases ( 101 eyes ) suffered from glaucoma were randomly divided into two groups, observation group and control group. Thirty-nine cases ( 51 eyes ) in the observation group underwent trabeculectomy with adjustable sutures, the control group (39 cases, 50 eyes) only adopted trabeculectomy.RESULTS: Compared Preoperative IOP in two groups, the difference was not statistically significant (P>0. 05). After 6mo, IOP were decreased compared with preoperative in two groups, and that in observation group was lower than control group, the difference was statistically significant ( P CONCLUSION: The adjustable sutures combined with trabeculectomy for glaucoma can significantly reduce the postoperative complications. The curative effect is exact and clinically applicable.