Suture Contamination Rate in Adjustable Suture Strabismus Surgery

Patients will be randomized into 1 of 2 groups: those who received 1 drop of 5%
povidone-iodine instilled directly over the sliding noose at surgery completion (group 1) and
those who did not receive povidone-iodine at the end of the surgery (group 2).

Institutional standard surgical preparation will be performed in all patients with 5%
povidone-iodine solution on the periocular skin and eyelid margins, followed by instillation
of 1 drop of 5% povidone-iodine into the conjunctival cul-de-sac.

All operations will be performed using a sliding noose technique with a polyglactin 6-0
suture (Vicryl, Ethicon Inc). If a patient undergoes surgery on more than 1 muscle in the
same eye, a 1-cm section of suture proximal to the knot will be collected from the
nonadjustable suture as a control. The control suture will be placed in a tube with 2 mL of
trypticase soy broth and agitated for 1 minute. At the end of surgery, patients in group 1
will receive a drop of povidone-iodine. A strip of neomycin sulfate, polymyxin B sulfate, and
dexamethasone ophthalmic ointment will be then applied into the lower conjunctival fornix to
patients in both groups.

Inclusion Criteria:

- All strabismus patients age ≥ 18 years scheduled for strabismus surgery with
adjustable sutures at the Bascom Palmer Eye Institute will be invited to participate.

Exclusion Criteria:

- Patient who has a history of allergy to povidone-iodine.

- Disorders affecting immune function.

- Patient who is unwilling to participate in the study