ABSTRACT
Objective To observe the clinical characteristics and surgical methods of strabismus following external approach for retinal detachment,and explore the common factors related to deviation angles of strabismus.Methods Twenty-five cases of secondary strabismus following external approach for retinal detachment underwent strabismus surgery were recruited,and the follow-up time was from 5 months to 41 months.Ophthalmic examinations were performed before operation.Clinical characteristics of these cases were observed by intraoperative exploration,including preoperative and postoperative eye position and ocular movement (at 1 week and further followup).The preoperative and postoperative deviation angles of strabismus were evaluated according to the times of retinal detachment operation,postoperative BCVA and the surgery procedure of hang-back recession.Results Before strabismus operation,all cases underwent abnormal eye-movements,8 cases suffered from diplopia,and scar adhesions were observed in all involved ocular muscles during operation.Seven cases underwent weakening procedure of extraocular muscle,18 cases underwent weakening procedure plus strengthening procedure.Ten cases underwent hang-back recession among them.At 1 week and the final follow-up,the eyeball in21 cases and 15 cases were in position,4 cases and 9 cases were in undercorrection,5 cases and 7 cases were in limitation,and 2 cases and 1 case were in diplopia.The more operations were performed in retinal detachment,the more scar adhesions were presented,and statistical significance existed with the mean deviation angles before and after operation(in a week) between cases that had one-time and over-one-time of retinal detachment surgery (P =0.01,0.00).No difference of mean deviation angles was found at one week after operation and at follow-ups between the cases with and without hang-back recession (P =0.26,0.63).Conclusion Abnormal eyemovements,diplopia and scar adhesion are the most common clinical characteristics of strabismus following retinal detachment surgery.Times of retinal detachment operation and postoperative BCVA can influence the deviation angles of strabismus,and hang-back recession seems the safe and effective method of strabismus surgery.
ABSTRACT
Recently hang-back recession is chosen instead of conventional recession to get better result in strabismus surgery. Jampolsky method, a popular method of hang-back recession, has some draw-backs; the extraocular muscle width can be decreased, the center of the muscle can be sagging posteriorly, and the amount of recession can be somewhat shortened than expected in operation. Accordingly, we devised a new modified hang-back recession and compared with Jampolsky method. Two months after respective operation in 7 albino rabbits, the width of the muscle comparing to preoperative condition, the amount of recession, and the sagging of middle part of the muscle were evalvated in comparison with the preoperative findings. The width of muscles was significantly shortened in Jampolsky method in comparison with preoperative condition (p0.05). The amount of recession by Jampolsky method was significantly shortened than expected in operation (p0.10). The significant sagging of the muscle was found with Jampolsky method (pO.lO). In review of these findings, our new method is devoid of some draw backs of Jampolsky method.