Practical aspects and efficacy of intraoperative adjustment in concomitant horizontal strabismus surgery.
OBJECTIVE
To analyze the practical aspects and advantages of one-stage adjustable surgery under topical anesthesia in concomitant horizontal strabismus.


METHODS
A retrospective review of 363 patients was completed to assess (1) the frequency of need to perform adjustment, (2) the amount and pattern of adjustment, and (3) the final alignment at least 6 months after surgery. Intraoperative adjustment was performed strictly toward the aim of orthophoria or slight overcorrection (heterophoria < 6 prism diopters [PD]) while avoiding diplopia.


RESULTS
Of the 363 patients, 261 (72%) required intraoperative adjustment. Of these, 85% of exotropes underwent a decreased amount of surgery compared with the standard amount, whereas 58% of esotropes underwent an increased amount of surgery. Forty-two patients underwent a one-muscle surgery instead of the scheduled two-muscle surgery, and all had less than 35 PD preoperative angle of deviation. Success rates were 83% in all patients with one-stage adjustable sutures and 87% in patients who underwent adjustment. In 42 patients with one-muscle surgery instead of two-muscle surgery, 32 (76%) obtained successful results.


CONCLUSIONS
Intraoperative adjustment was effective in concomitant horizontal strabismus surgery and can provide the opportunity to avoid a large overcorrection, especially in cases with moderate angle horizontal muscle surgery.
Yi
Jeong Ho
JH
Institute of Vision Research , Ajou University School of Medicine, Suwon, Korea.
Chung
Seung Ah
SA
Chang
Yoon Hee
YH
Lee
Jong Bok
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004172:Diplopia / Q000517:prevention & control; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery*; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*; D055815:Young Adult