Ocular Complications of Strabismus Surgery

Abstract

Background: To evaluate ocular complications of strabismus surgery at the Department of Strabismus and Neuroophthalmology in our clinic. Methods: The medical records of patients who underwent strabismus surgery between March 1999 and February 2013 were retrospectively reviewed. Patients with minor ocular complications such as wound irregularities, conjunctivitis, subconjunctival hemorrhage, and less than six-month follow-up periods were excluded from the study. Employed strabismus surgeries included recessions, resections, muscle advancements, inferior oblique myectomies, and muscle transpositions. Results: Our case series are comprised of 1468 patients who underwent strabismus surgery. The ages of the patients ranged from 6 to 80 years. Recognized primary ocular complications were noted in eight patients (0.5%). Scleral perforation with retinal break was observed in one myopic patient during retrobulbar anesthesia. Medial rectus rupture occurred during medial rectus recession in one patient with chronic complete sixth nerve palsy. Conjunctival cyst occured postoperatively in one patient with partially refractive accommodative esotropia who had bilateral medial rectus recession. Corneal dellen developed postoperatively in five patients with exotropia. Conclusion: Ocular complications of strabismus surgery are usually treatable. Damage to ocular structures can be prevented by meticulous surgical approach. Close postoperative follow-up is required in all cases.

Novo gancho muscular milimetrado para cirurgia de estrabismo

“…(1) Esse passo obrigatoriamente requer a presença do auxiliar para a sustentação dos referidos ganchos. (5) As formas de manusear e posicionar esses ganchos podem interferir no resultado e na segurança do procedimento, considerando as pequenas disparidades nas marcações, variações no local das inserções e, ainda mesmo que raras, as possibilidades de perfuração do globo e ruptura dos músculos. (5,6) Um auxiliar com boa experiência é importante para dar maior segurança ao cirurgião e ao paciente, principalmente durante a curva de aprendizado dos jovens cirurgiões.…”

The Suh Muscle Hook: A New Muscle Hook for Tight Extraocular Muscles during Strabismus Surgery

“…Surgical recession of tight extraocular muscle can be challenging due to restricted globe rotation which may prevent the optimal muscle exposure required for surgery [5]. Passing a needle anterior to the hook can be difficult due to the inability to stretch the taut muscle to provide enough space for the needle, which may result in additional resection or rupture of an already tight muscle [6] [7] [8]. Tight extraocular muscles often indent the globe and cause scleral thinning in that area [5].…”