Minimally invasive strabismus surgery versus paralimbal approach: A randomized, parallel design study is minimally invasive strabismus surgery worth the effort?

• Main Authors: Richa Sharma, Abadan K Amitava, Sadat AO Bani
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Mean deviation; non-proliferative diabetic retinopathy; short fluctuations; short wave automated perimetry; standard automated perimetry; Antimicrobial effect; conventional silicone oil; endophthalmitis agents; heavy silicone oil; Keratoconus; modified deep anterior lamellar keratoplasty; steep corneal curvature; Bevacizumab; branch retinal vein occlusion; intravitreal; macular edema; triamcinolone; Blindness; disability evaluation; quality of life; visual acuity; Mitomycin C; pterygium recurrence; pterygium surgery; subconjunctival bevacizumab injection; Imaging in glaucoma; optical coherence tomography; pediatric; retinal nerve fiber layer; Autogenous tissue grafting; lacrimal drainage system; lacrimal fossa; bypass surgery; Cornea; excimer laser; growth factors; myopia; photorefractive keratectomy; Triamcinolone acetonide; human trabecular meshwork cells; in vitro; Hyperopic implantable collamer lens; myopic implantable collamer lens; optical quality; wavefront aberrations; Dacryocystorhinostomy; nasolacrimal duct obstruction; silicone tube; Age; anterior chamber depth; body height; primary angle closure glaucoma; sex; Children; eye injury vitrectomy study; eye injury; trauma; vitrectomy; Corneal biomechanics; corneal hysteresis; corneal resistance factor; intraocular pressure; keratoplasty; ocular response analyser; Aspherical intraocular lens; quality of vision; spherical aberrations; Benign; excision; lids and caruncle; no recurrence; ocular FH; inflammation; sterile endophthalmitis; Carotid artery disease; ocular ischemic syndrome; retinal emboli; cataract; India; low vision; population; Awareness; glaucoma; knowledge; North India; Aphakia; capsular support; inadequate; intraocular lens implantation; iris fixation; Extra macular BRVO; hyperhomocysteinemia; multiple BRVO; Medial canthus; recurrent; retiform hemangioendothelioma; Optic atrophy; osteopetrosis; Lacrimal abscess; dacryocystitis; cardiobacterium hominis; Ethambutol; linezolid; optic neuropathy; Blunt trauma; horseshoe-shaped macular tear; spectral-domain optical coherence tomography; Caesarian section; combined occlusion; non-ocular surgery; perioperative visual loss; Choroidal thickness; enhanced depth imaging; high-altitude retinopathy; Cosmesis; incision; minimal; strabismus; surgery
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2014;volume=62;issue=4;spage=508;epage=511;aulast=Sharma
• ISSN: 0301-4738; 1998-3689

Introduction : Minimal access surgery is common in all fields of medicine. We compared a new minimally invasive strabismus surgery (MISS) approach with a standard paralimbal strabismus surgery (SPSS) approach in terms of post-operative course. Materials and Methods: This parallel design study was done on 28 eyes of 14 patients, in which one eye was randomized to MISS and the other to SPSS. MISS was performed by giving two conjunctival incisions parallel to the horizontal rectus muscles; performing recession or resection below the conjunctival strip so obtained. We compared post-operative redness, congestion, chemosis, foreign body sensation (FBS), and drop intolerance (DI) on a graded scale of 0 to 3 on post-operative day 1, at 2-3 weeks, and 6 weeks. In addition, all scores were added to obtain a total inflammatory score (TIS). Statistical Analysis: Inflammatory scores were analyzed using Wilcoxon′s signed rank test. Results: On the first post-operative day, only FBS (P = 0.01) and TIS (P = 0.04) showed significant difference favoring MISS. At 2-3 weeks, redness (P = 0.04), congestion (P = 0.04), FBS (P = 0.02), and TIS (P = 0.04) were significantly less in MISS eye. At 6 weeks, only redness (P = 0.04) and TIS (P = 0.05) were significantly less. Conclusion: MISS is more comfortable in the immediate post-operative period and provides better cosmesis in the intermediate period.