Investigation of Hemodynamic Changes in the Ophthalmic Artery using Color Doppler Imaging after Strabismus Surgery

PURPOSE: We investigated hemodynamic changes in the ophthalmic artery (OA) using color Doppler imaging (CDI) after two horizontal rectus muscles surgery. METHODS: Eyes of the surgical group (n=18) underwent surgery on two horizontal rectus muscles, and the control group was the contralateral eyes. CDI of the OA was performed before operation and on postoperative days (POD) 1, 7 and 30. Peak systolic (Vmax), end diastolic (Vmin), and mean (Vmean) blood flow velocities were measured, and resistivity index (RI) and pulsatility index (PI) were calculated. RESULTS: Vmax, Vmin and Vmean were significantly higher, and RI and PI were significantly lower in the surgical group than in the control group on POD 1 (p< 0.05). In the surgical group, Vmax, Vmin and Vmean were significantly higher, and RI and PI were significantly lower, on POD 1 than those mesured on other days (p< 0.05). CONCLUSIONS: We showed that surgery on the two horizontal rectus muscles increased OA blood flow during the early postoperative period.

Recession of 4 Rectus Muscles for Neovascular Glaucoma or Absolute Glaucoma

We have performed recession of all 4 rectus muscle in 8 eyes with neovascular or absolute glaucoma. The visual acuity of these eyes ranged fram no light perception to recognition of hand motion. As the purpose of surgery was to destroy all anterior ciliary arteries from the rectus muscles, after performing 2mm recessions on all 4 rectus muscles we applied cryotherapy on the oclera from he original rite to the mear insertion site. The cases were followed up for periods ranging from 3 to 19 months, with an average of 10.3 months. At the end of follow-up periods, we observed a statistically significant drop (p<0.05) in the intraocular pressure level, from the preoperative leveI of 49.8 +/- 7.9 mmHg (mean +/-SD) to 36.6 +/- 18.1 mmHg without any additional medical therapy. However, the decreases were not notable. In the treatment of neovascular glaucoma for absolute glaucoma, we have found that simultaneous disruption of all anterior ciliary arteries through anterior segment ischemia will not result in a satisfactory decrease in postoperative intraocular pressure.