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Evaluation of the ultrasound biomicroscope in strabismus surgery
Patrick Watts1, David Smith, Leslie Mackeen
1Department of Ophthalmology, The Hospital for Sick Children, Ontario Canada.
Insights
Ultrasound biomicroscopy (UBM) reliably measures horizontal extraocular muscle insertion distances from the limbus in pediatric strabismus surgery. This tool aids surgeons in pre-operative planning for improved surgical accuracy.
Area of Science:
- Ophthalmology
- Surgical Technology
- Pediatric Eye Care
Background:
- Accurate measurement of extraocular muscle insertion is crucial for successful strabismus surgery.
- Traditional methods for measuring muscle insertion distances can be invasive or lack precision.
- Pre-operative imaging can potentially improve surgical planning and outcomes in pediatric strabismus.
Purpose of the Study:
- To evaluate the capability of ultrasound biomicroscopy (UBM) in determining the distance of horizontal extraocular muscle insertions from the limbus.
- To assess the reliability of UBM measurements compared to intraoperative surgical measurements in children.
Main Methods:
- 51 children undergoing horizontal muscle strabismus surgery were included.
- A 50 MHz UBM was used pre-operatively to measure muscle insertion distances.
- Intraoperative caliper measurements were performed by a masked surgeon; intraclass correlation coefficient (ICC) was calculated.
Main Results:
- UBM measurements showed good agreement with surgical measurements, with an ICC of 0.71.
- Mean medial rectus (MR) insertion distance was 5.2 mm (UBM) vs. 5.2 mm (surgical).
- Mean lateral rectus (LR) insertion distance was 6.9 mm (UBM) vs. 6.4 mm (surgical).
Conclusions:
- Ultrasound biomicroscopy (UBM) is a reliable tool for pre-operative estimation of horizontal rectus muscle insertion distances.
- UBM can aid in surgical planning for pediatric strabismus by providing accurate distance measurements.
- This non-invasive technique enhances the precision of strabismus surgery in children.
Purpose:
This study was done to determine the ability of the ultrasound biomicroscope (UBM) to define the distance of the horizontal extraocular muscle insertions from the limbus in children undergoing strabismus surgery.
Methods:
A total of 51 children undergoing primary surgery on their horizontal muscles were recruited for this study. The 50 MHz UBM was used before surgery on the muscle(s) requiring an operation to define the distance of the insertion of the horizontal rectus muscle(s) from the limbus. These data were stored on a computer and masked from the surgeon who measured the actual insertion from the limbus with calipers intraoperatively. An intraclass correlation coefficient was calculated to determine the correlation of the UBM measurement with that performed during surgery.
Results:
Measurement of the distance of the insertions from the limbus were taken on 79 muscles of the 51 patients: 44 medial rectus (MR) and 35 lateral rectus (LR). Mean age of the patients was 6.4 +/- 3.7 years (range, 1-15). A total of 29 children (56.9%) were female. The mean distance of MR from the limbus measured surgically was 5.2 +/- 0.6 mm (range, 4-6 mm; median, 5 mm) and measured with the UBM was 5.2 +/- 0.9 mm (range, 4-7.6 mm; median, 5.3 mm). Comparable results for the LR muscles were 6.4 +/- 0.6 mm (range, 5.5-7.5 mm; median, 6.5 mm) and 6.9 +/- 0.7 mm (range, 5.9-8.4 mm; median, 6.9 mm), respectively. An intraclass correlation coefficient of 0.71 signified good agreement between the surgical and UBM measurements of the distance from the limbus of the horizontal rectus muscle insertions.
Conclusion:
The UBM could be used reliably as a tool before surgery to estimate the distance of the horizontal rectus muscles from the limbus in children with strabismus.