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A modified technique for rectus muscle plication in minimally invasive strabismus surgery
1Department of Strabismology and Neuro-Ophthalmology, Kantonsspital St. Gallen, St. Gallen, Switzerland. daniel.mojon@kssg.ch
Summary
A new minimally invasive strabismus surgery (MISS) rectus muscle plication technique, marginal dissection (MADI), reduces conjunctival swelling and redness compared to total dissection (TODI). MADI is equally effective for strabismus correction.
Area of Science:
- Ophthalmology
- Surgical Techniques
Background:
- Strabismus surgery aims to restore ocular alignment.
- Minimally Invasive Strabismus Surgery (MISS) techniques are evolving to reduce patient morbidity.
- Rectus muscle plication is a common surgical approach.
Purpose of the Study:
- To introduce and evaluate a novel, minimally invasive strabismus surgery (MISS) technique for rectus muscle plication.
- To compare the outcomes of marginal dissection (MADI) plication with total dissection (TODI) plication.
Main Methods:
- A retrospective comparison of 40 patients undergoing MISS recession/MADI plication versus 49 patients undergoing MISS recession/TODI plication.
- Analysis of postoperative alignment, binocular single vision, visual acuity, refraction, conjunctival abnormalities, dose-response, and complications over 6 months.
Main Results:
- MADI plication resulted in significantly less conjunctival swelling and redness postoperatively compared to TODI plication (p < 0.01).
- No significant differences were observed between MADI and TODI plication in terms of dose-response for esodeviations or exodeviations.
- Final alignment, binocular single vision, visual acuity, refractive changes, and complication rates were similar between the two techniques.
Conclusions:
- Marginal dissection (MADI) plication is a feasible and effective alternative to total dissection (TODI) plication in MISS.
- MADI plication, performed without a spatula, offers the advantage of reduced postoperative conjunctival inflammation.
