Simultaneous posterior eyelid ptosis repair and strabismus surgery: a single-stage approach

Mangan, Mehmet Serhat; Bolaç, Rüveyde; Yıldız, Mehmet Kamil; İmamoğlu, Serhat; Vural, Ece Turan; Yenerel, Nursal Melda

doi:10.5935/0004-2749.20230020

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“…Although cyst formation has not been described in the literature postoperatively after Botox injection, it can also cause serious complications such as vitreous hemorrhage and retinal detachment [ 33 ]. Another procedure to minimize surgical burden on patients, the combined resection of Müller’s muscle and conjunctiva with tarsectomy and horizontal strabismus surgery, did not show an increased risk of the formation of postoperative cysts in a small collective [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Characterization and Classification of Postoperative Cysts After Strabismus Surgery: Clinical, Histological, and Anterior Segment OCT Analysis in a Large German Cohort

Hufendiek,

Bredt,

Binter

et al. 2023

Ophthalmol Ther

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Introduction In this work, we provide a detailed characterization of a rare complication—subconjunctival cyst formation after strabismus surgery—in a large German cohort. Methods We conducted a retrospective analysis of 822 consecutive patients who underwent strabismus surgery between 2015 and 2022. The patients received comprehensive eye and orthoptic examinations preoperatively, at 1 day, and at 3 months postoperatively. Cysts were analyzed with slit-lamp examination, anterior segment optical coherence tomography (AS-OCT), and histopathological subsumption. Results Nineteen cases of postoperative cysts were observed (2.3%), 12 of which underwent surgical revision. Clinical evaluation including slit-lamp and AS-OCT as well as histological analysis resulted in a classification of three types of cysts: type 1, which is a single hyporeflective cyst, type 2, which is a multilobular hyporeflective cyst, and type 3, a dense hyperreflective granulomatous-like cyst. Eta (η) correlation ratio analysis could show a correlation between time of clinical appearance and type of cyst (Eta = 0.63). Most cysts developed within 20 days after surgery. Not only did cysts more frequently affect the medial rectus muscle, which in most cases underwent a shortening procedure (11/19 tucks, 4/19 resections) for intermittent exotropia (X(T)), but the cyst also formed earlier than in the lateral rectus muscle (Eta = 0.45). No correlation could be shown between the type of surgical procedure and time of cyst occurrence (Eta = 0.1). Patient age and cyst type correlated strongly (Eta = 0.47). The underlying type of strabismus did not correlate with the type of cyst observed. Conclusions Our cases showed a strong positive correlation to the type of strabismus (X(T)), age (young patients), and the procedure (tuck/resection). We introduce a grading system for postoperative cysts after strabismus surgery, complementing histopathology and slit-lamp aspects with AS-OCT information.

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Section: Discussionmentioning

confidence: 99%