Cargando…

Reoperation in Horizontal Strabismus and its Related Risk Factors

This study was performed to determine the surgical outcomes and the related risk factors of second operation in patients with residual horizontal deviations. In this interventional case series study, a total of 119 patients with a history of reoperation were included (39 exotropia and 80 esotropia)....

Descripción completa

Detalles Bibliográficos
Autores principales: RAJAVI, Zhale, GOZIN, Mohammad, SABBAGHI, Hamideh, BEHRADFAR, Narges, KHEIRI, Bahareh, FAGHIHI, Mohmmad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medical Hypothesis, Discovery & Innovation Ophthalmology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6146237/
https://www.ncbi.nlm.nih.gov/pubmed/30250856
_version_ 1783356365975060480
author RAJAVI, Zhale
GOZIN, Mohammad
SABBAGHI, Hamideh
BEHRADFAR, Narges
KHEIRI, Bahareh
FAGHIHI, Mohmmad
author_facet RAJAVI, Zhale
GOZIN, Mohammad
SABBAGHI, Hamideh
BEHRADFAR, Narges
KHEIRI, Bahareh
FAGHIHI, Mohmmad
author_sort RAJAVI, Zhale
collection PubMed
description This study was performed to determine the surgical outcomes and the related risk factors of second operation in patients with residual horizontal deviations. In this interventional case series study, a total of 119 patients with a history of reoperation were included (39 exotropia and 80 esotropia). Cases with consecutive strabismus, muscular palsy, systemic disease, lack of ocular fixation, and those, who had vertical deviation and Dissociated Vertical Deviation (DVD)>5 Prism Diopters (pd) were excluded. Medial Rectus (MR) resection in residual Exotropia (XT) and Lateral Rectus (LR) resection in residual Esotropia (ET) were performed. Unilateral or bilateral operations were considered if the preoperative residual deviation was < 20 pd or > 20 pd, respectively. Success of the reoperation was considered if the postoperative angle of deviation was ≤ 10 pd. Unilateral and bilateral MR resection was performed in 26% and 74% of patients with XT, respectively, with greater dose response in unilateral cases (2.8 versus 2.6 mm/pd). Successful surgical outcomes were observed in 94.9% of patients with XT. Unilateral and bilateral LR resection was also performed in patients with residual ET, each in 50% of patients. Unilateral cases showed greater dose-response compared to bilateral ones (2.6 versus 2 mm/pd) and successful surgical outcomes were observed in 83.8% of patients with ET. No variable was found as a risk factor of reoperation in both groups. In conclusion, both LR and MR resection are easy and predictable surgical approaches with high success rate in patients with residual ET and XT. Generally, MR resection is more effective than LR resection. Unilateral operation is less recommended in the residual exotropic group, due to its lower success compared to the bilateral operation. Unfortunately, none of the mentioned variables were found to be the risk factor of reoperation in the sampled patients.
format Online
Article
Text
id pubmed-6146237
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medical Hypothesis, Discovery & Innovation Ophthalmology
record_format MEDLINE/PubMed
spelling pubmed-61462372018-09-24 Reoperation in Horizontal Strabismus and its Related Risk Factors RAJAVI, Zhale GOZIN, Mohammad SABBAGHI, Hamideh BEHRADFAR, Narges KHEIRI, Bahareh FAGHIHI, Mohmmad Med Hypothesis Discov Innov Ophthalmol Original Article This study was performed to determine the surgical outcomes and the related risk factors of second operation in patients with residual horizontal deviations. In this interventional case series study, a total of 119 patients with a history of reoperation were included (39 exotropia and 80 esotropia). Cases with consecutive strabismus, muscular palsy, systemic disease, lack of ocular fixation, and those, who had vertical deviation and Dissociated Vertical Deviation (DVD)>5 Prism Diopters (pd) were excluded. Medial Rectus (MR) resection in residual Exotropia (XT) and Lateral Rectus (LR) resection in residual Esotropia (ET) were performed. Unilateral or bilateral operations were considered if the preoperative residual deviation was < 20 pd or > 20 pd, respectively. Success of the reoperation was considered if the postoperative angle of deviation was ≤ 10 pd. Unilateral and bilateral MR resection was performed in 26% and 74% of patients with XT, respectively, with greater dose response in unilateral cases (2.8 versus 2.6 mm/pd). Successful surgical outcomes were observed in 94.9% of patients with XT. Unilateral and bilateral LR resection was also performed in patients with residual ET, each in 50% of patients. Unilateral cases showed greater dose-response compared to bilateral ones (2.6 versus 2 mm/pd) and successful surgical outcomes were observed in 83.8% of patients with ET. No variable was found as a risk factor of reoperation in both groups. In conclusion, both LR and MR resection are easy and predictable surgical approaches with high success rate in patients with residual ET and XT. Generally, MR resection is more effective than LR resection. Unilateral operation is less recommended in the residual exotropic group, due to its lower success compared to the bilateral operation. Unfortunately, none of the mentioned variables were found to be the risk factor of reoperation in the sampled patients. Medical Hypothesis, Discovery & Innovation Ophthalmology 2018 /pmc/articles/PMC6146237/ /pubmed/30250856 Text en ©2018, Med Hypothesis Discov Innov Ophthalmol. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial 3.0 License (CC BY-NC 3.0) (https://creativecommons.org/licenses/by-nc/3.0/) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.
spellingShingle Original Article
RAJAVI, Zhale
GOZIN, Mohammad
SABBAGHI, Hamideh
BEHRADFAR, Narges
KHEIRI, Bahareh
FAGHIHI, Mohmmad
Reoperation in Horizontal Strabismus and its Related Risk Factors
title Reoperation in Horizontal Strabismus and its Related Risk Factors
title_full Reoperation in Horizontal Strabismus and its Related Risk Factors
title_fullStr Reoperation in Horizontal Strabismus and its Related Risk Factors
title_full_unstemmed Reoperation in Horizontal Strabismus and its Related Risk Factors
title_short Reoperation in Horizontal Strabismus and its Related Risk Factors
title_sort reoperation in horizontal strabismus and its related risk factors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6146237/
https://www.ncbi.nlm.nih.gov/pubmed/30250856
work_keys_str_mv AT rajavizhale reoperationinhorizontalstrabismusanditsrelatedriskfactors
AT gozinmohammad reoperationinhorizontalstrabismusanditsrelatedriskfactors
AT sabbaghihamideh reoperationinhorizontalstrabismusanditsrelatedriskfactors
AT behradfarnarges reoperationinhorizontalstrabismusanditsrelatedriskfactors
AT kheiribahareh reoperationinhorizontalstrabismusanditsrelatedriskfactors
AT faghihimohmmad reoperationinhorizontalstrabismusanditsrelatedriskfactors