Efficacy of modified Parks incision in the surgery for correction of strabismus in children / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of modified parks incision in the surgery for correction of strabismus in children.Methods:Sixty children patients with strabismus who received treatment in Shanxi Hospital of Integrated Traditional and Western Medicine, China between January 2015 and January 2020 were included in this study. They were randomly assigned to receive surgery with either a trapezoidal flap incision (control group, n = 30) or modified Parks incision (modified Parks group, n = 30). Time to tear film break-up, amount of tears secreted, and the angles of deviation in strabismus were compared before and after surgery. The efficacy was evaluated by corneal fluorescein staining score. Postoperative complications were compared between the two groups. Results:Before surgery, there were no significant differences in the time to tear film break-up and the amount of tears secreted between the two groups (both P > 0.05). After surgery, the time to tear film break-up and the amount of tears secreted were (9.16 ± 1.74) seconds, (7.51 ± 1.36) mm/5 minutes in the modified Parks group and they were (7.57 ± 1.45) seconds and (6.05 ± 1.14) mm/5 minutes, respectively in the control group. After surgery, the time to tear film break-up and the amount of tears secreted in each group were shortened or decreased compared with before treatment, and these two indices in the modified Parks group were significantly shorter or less than those in the control group ( t = 3.845, 4.506, both P < 0.05). Before surgery, there were no significant differences in corneal fluorescein staining score and the angles of deviation in strabismus between the two groups (both P > 0.05). After surgery, corneal fluorescein staining score and the angles of deviation in strabismus in the modified Parks group were (5.14 ± 1.51) points and (10.68 ± 1.75) PD, respectively and they were (6.25 ± 1.73) points and (15.95 ± 2.14) PD, respectively in the control group. After surgery, corneal fluorescein staining score or the angle of deviation in strabismus was increased or decreased in each group. The corneal fluorescein staining score and the angle of deviation in strabismus in the modified Parks group were significantly lower than those in the control group ( t = 2.648, 10442, both P < 0.05). Total effective rate in the modified Parks group was significantly higher than that in the control group [96.7% (29/30) vs. 80.0% (24/30), χ2= 4.043, P < 0.05]. The incidence of postoperative complications and discomfort rate in the modified Parks group were 0.0% (0/30) and 53.3% (16/30), respectively, which were significantly lower than those in the control group 13.3% (4/30) and 80.0% (24/30), χ2 = 4.286, 4.800, both P < 0.05]. Conclusion:Modified Parks incision for corrective strabismus surgery can better correct the angle of strabismus, protect the stability of tear film function, reduce postoperative complications and decrease postoperative discomfort rate compared with trapezoidal flap incision.