Purpose: Minimally invasive surgeries are gaining popularity. We compared two different approaches to rectus muscles: namely the standard para limbal (SPL) and the single para-muscular (SPM).
Methods: Thirty-six patients planned for monocular horizontal strabismus surgery were block randomized to SPL and SPM approach. SPM approach involved a single para-muscular 10-mm conjunctival incision levelled at the inferior border of rectus muscle. We compared the post-operative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6-8 weeks; scar visibility and success rates at 6-8 weeks and operation duration in minutes. We compared the results using Mann-Whitney U-test for inflammatory grades, Fisher's exact test for proportions, and t-test for parametric measures. Significance was set at P < 0.05.
Results: On postoperative follow-up at any time point, no significant difference was found on comparing inflammatory grades, scar visibility, and success rates. In terms of duration, SPL approach was on an average 21.5 minutes quicker than SPM (P = <0.001).
Conclusion: The SPM is comparable to the SPL approach in terms of postoperative comfort and appearance, but takes significantly longer to accomplish.
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http://dx.doi.org/10.4103/ijo.IJO_2059_21 | DOI Listing |
Am J Ophthalmol
January 2025
Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address:
Introduction: Botulinum toxin is an alternative to conventional strabismus surgery for treatment for acute, acquired, comitant esotropia (AACE). Previous studies suggest that the two treatment approaches may be equally effective for 6 months. The purpose of our study was to determine whether botulinum toxin remains as effective as strabismus surgery for 36 months after treatment.
View Article and Find Full Text PDFJ Pediatr Ophthalmol Strabismus
December 2024
Purpose: To compare the results of botulinum toxin A injection and bridge Faden operation performed with bimedial rectus recession in the treatment of large-angle esotropia.
Methods: The medical charts of patients with large-angle esotropia who underwent bimedial rectus recession combined with the Faden operation or botulinum toxin A injection between January 2018 and March 2022 were retrospectively screened. The degree of deviations measured before surgery and at 1, 3, 6, and 12 months after surgery were compared between the two groups.
Purpose: To compare changes of vertical palpebral fissure height after bilateral lateral rectus (BLR) recessions versus unilateral lateral rectus (LR) recession and medial rectus (MR) muscle scleral plication, for treatment of intermittent exotropia.
Methods: This prospective, comparative, randomized study included 40 patients with intermittent exotropia who were divided into two groups: 20 patients who underwent BLR recessions (BLR recession group) and 20 patients who underwent unilateral LR recession and MR muscle scleral plication (recession-plication group). Eyelid evaluation included measurement of margin reflex distance 1 (MRD1) and margin reflex distance 2 (MRD2) at 1 week, 6 weeks, and 3 months postoperatively.
JAMA Ophthalmol
January 2025
The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: While urban counties maintain higher densities of ophthalmologists than rural counties, the geographic distribution of ophthalmic surgical subspecialists has not yet been elucidated. A potential workforce discrepancy may impact the burden of care faced by rural surgeons.
Objective: To assess the geographic distribution of the ophthalmic subspecialist surgeon workforce and evaluate factors associated with practicing in rural areas.
Zhonghua Yan Ke Za Zhi
January 2025
Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin300020, China.
To explore the efficacy of the modified lateral rectus muscle splitting and nasal transposition surgery in treating large-angle exotropia caused by oculomotor nerve palsy and its impact on ocular motility. Retrospective case series study. Data was collected from patients diagnosed with large-angle exotropia due to oculomotor nerve palsy and treated by modified lateral rectus muscle splitting and nasal transposition surgery at the Tianjin Eye Hospital from January 2020 to October 2023.
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