Minimally invasive strabismus surgery for horizontal rectus muscle reoperations

Area of Science:

• Ophthalmology
• Surgical Techniques

Background:

• Strabismus reoperations often involve extensive tissue manipulation.
• Minimally invasive techniques may offer advantages in reducing surgical trauma.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel minimally invasive strabismus surgery (MISS) technique for rectus muscle reoperations.
• To assess the impact of MISS on postoperative recovery and ocular alignment.

Main Methods:

• A consecutive series of patients underwent rectus muscle reoperation using a novel MISS technique with small radial incisions.
• Procedures included recession, advancement, or plication performed through a dissected tunnel.
• Data on visual acuity, deviation, and postoperative symptoms were collected.

Main Results:

• 86 horizontal rectus muscles were reoperated in 62 eyes of 51 patients with prior strabismus surgeries.
• Significant reductions in esodeviations and exodeviations were observed at 6 months postoperatively (p<0.001 for esotropia, p<0.005 for exotropia).
• Postoperative swelling was reduced, with only minor ocular surface complications. Stereovision improved (p<0.01).

Conclusions:

• A small-cut, minimal dissection MISS technique is suitable for rectus muscle reoperations.
• The MISS technique appears to minimize conjunctival and lid swelling in the early postoperative period.
• This approach offers a viable alternative for complex strabismus reoperations.