Twist knot: A new sliding noose in adjustable suture strabismus surgery

Kiyo Shibata, Ichiro Hamasaki, Takehiro Shimizu, Reika Kono, Hiroshi Ohtsuki, Yuki Morizane, Fumio Shiraga

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


To permit noose movement without fraying the sutures following strabismus surgery, we designed a new sliding noose, the "twist knot" and investigated its advantages and disadvantages. We measured the tensile strength required to move the twist knot in a tightly tied state (134±19 gf) and in a loosened state (21±7 gf), and that required to move the conventional sliding noose in a tightly tied state (48±14 gf), and used the Kruskal-Wallis test to compare them. A significant difference was observed among the three tensile strengths (p < 0.001). The twist knot technique allowed easy sliding without the multifilament braided suture becoming frayed and a knot to be firmly fixed without slipping. However, if the 2 strings of the pole sutures exit from the sclera at 2 widely separated positions, the sliding noose may become slack. Therefore, the distance between the pole sutures should be small. The simple twist knot technique was found to be an effective approach following adjustable surgery of strabismus.

Original languageEnglish
Pages (from-to)463-468
Number of pages6
JournalActa medica Okayama
Issue number5
Publication statusPublished - 2019


  • Adjustable suture
  • Esotropia
  • Strabismus surgery
  • Tensile strength
  • The new sliding noose method

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


Dive into the research topics of 'Twist knot: A new sliding noose in adjustable suture strabismus surgery'. Together they form a unique fingerprint.

Cite this