{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:54:47Z","timestamp":1791561287947,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the efficacy of tendon elongation using bovine pericardium (Tutopatch\u00ae) in complex strabismus surgeries, with a specific focus on longer follow\u2010up of postoperative outcomes and patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this pre\u2010post cohort study, the records of all patients who underwent tendon elongation strabismus surgery with Tutopatch\u00ae at Radboudumc and Amsterdam UMC were retrospectively reviewed. Eligible patients were invited for a single prospective follow\u2010up visit to assess long\u2010term outcomes. Strabismus angle (success defined as \u22645.71\u00b0 of orthotropia) and duction limitations (converted to a pseudo\u2010quantitative scale ranging from 0 to 5) were evaluated preoperatively, 1\u2009week postoperatively, 3\u2009months postoperatively and at longer intervals where possible. Patient satisfaction was measured on a Visual Analogue Scale at the prospective follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010nine participants (mean age 41.3\u2009\u00b1\u200918.4\u2009years) were included. Fifty\u2010one patients had childhood onset and eighteen patients had acquired onset of strabismus. Tutopatch\u00ae was predominantly used to correct the horizontal deviation. Long\u2010term follow\u2010up data (&gt;17.4\u2009weeks) were available for 49 patients (71%), with a median follow\u2010up of 124\u2009weeks (range 19.9\u2013431\u2009weeks) and surgical success was achieved in 73% (near) and 60% (distance). Duction limitations significantly increased postoperatively, especially in exodeviations, but improved over time and seemed to have minimal impact on ocular alignment in primary position. Patient satisfaction was very high (median VAS 9.0), with only weak\u2010to\u2010moderate correlation with ocular alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tutopatch\u00ae is a viable surgical option for tendon elongation in complex strabismus cases with favorable long\u2010term ocular alignment, mild duction limitation and high patient satisfaction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.70140","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T13:51:02Z","timestamp":1776347462000},"page":"818-827","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Tutopatch\u00ae assisted surgery for complex strabismus study:\n                    <scp>TASCS<\/scp>\n                    \u2010study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0975-6742","authenticated-orcid":false,"given":"Ires A. W.","family":"Verhees","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0435-096X","authenticated-orcid":false,"given":"Hinke Marijke","family":"Jellema","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Amsterdam UMC Location University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Marie E. L.","family":"Langenhorst","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Amsterdam UMC Location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3062-6544","authenticated-orcid":false,"given":"B. 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