Non-absorbable sutures use in bilateral lateral rectus recession reduces the rate of overcorrection in exotropia

To compare the incidence of consecutive esotropia post bilateral lateral rectus recession (BLR) surgery using absorbable compared to non-absorbable sutures for the treatment of childhood exotropia. Retrospective Cohort study. Medical records of all children who underwent BLR surgery between January 2019 and January 2022 in a single medical center by a single surgeon were analyzed. Either absorbable or non-absorbable sutures were used. The incidence of consecutive esotropia (greater than 8 PD) was the primary outcome. A total of 130 children were included. The mean age was 6.45 ± 3.13 years, 54% were female. Sixty-five of the children underwent surgery with the use of absorbable sutures and 65 with the use of non-absorbable sutures. Consecutive esotropia occurred in 14 children (21.5%) in the absorbable group and in 5 children (7.7%) in the non-absorbable group (OR = 3.29, 95% CI = 1.11-9.77; <i>p</i> = .025). After adjustment for follow-up time using the Kaplan - Meier survival analysis, the difference between groups remained significant (<i>p</i> = .049). Secondary surgery due to consecutive esotropia occurred in 10 children (15.4%) in the absorbable group and in 3 children (4.6%) in the non-absorbable group (OR = 3.75, 95% CI = 1.001-14.628; <i>p</i> = .04). There were no other complications in either of the groups. The use of non-absorbable sutures in BLR surgery reduces the incidence of consecutive esotropia compared to absorbable sutures.