title: Inadvertent scleral perforation after strabismus surgery: incidence and association with refractive error.
abstract: BACKGROUND
  Inadvertent scleral perforation is a rare but serious complication of extraocular muscle surgery for strabismus. We evaluated the incidence of unwanted scleral penetration after strabismus surgery and its association with refractive error.
  
  
  METHODS
  This cross-sectional noncomparative case series comprised 453 eyes from 236 patients who underwent strabismus surgery. After dilation, each patient had fundus examination using indirect binocular ophthalmoscope. Chorioretinal scars around the suture area, which presumed the previous scleral perforation, were detected. We assessed whether the presence of these scars was related to the degree of preoperative refractive error.
  
  
  RESULTS
  Mean postoperative follow-up was 52.44 (SD 30.07) months. Overall incidence of inadvertent penetration of the sclera was 1.77%. A total of 8 eyes (6 patients) showed chorioretinal scars, and all were myopic. Of these, 3 eyes were classified as mild myopia, 3 as moderate myopia, and the other 2 as severe myopia. The relationship between inadvertent scleral penetration and degrees of refractive error was weak but statistically significant (p = 0.001).
  
  
  CONCLUSIONS
  Inadvertent scleral perforation after strabismus surgery seems to be associated with myopic refractive error.
authors.affiliation: Institute of Vision Research, Department of Ophathalmology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyoungsoo
authors.initials: K
authors.lastname: Park
authors.forename: Samin
authors.initials: S
authors.lastname: Hong
authors.forename: Woosuk
authors.initials: W
authors.lastname: Chung
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Suk Ho
authors.initials: SH
authors.lastname: Byeon
authors.forename: Gong Je
authors.initials: GJ
authors.lastname: Seong
authors.forename: Jong Bok
authors.initials: JB
authors.lastname: Lee
authors.forename: Sueng-Han
authors.initials: SH
authors.lastname: Han
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D015807:Eye Injuries, Penetrating / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009216:Myopia / Q000209:etiology*; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications; D012307:Risk Factors; D012590:Sclera / Q000293:injuries*; D013285:Strabismus / Q000601:surgery*