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Astigmatic changes after horizontal rectus muscle surgery in intermittent exotropia
1Department of Ophthalmology & Visual Science, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
Korean Journal of Ophthalmology : KJO
|December 4, 2012
Summary
Horizontal rectus muscle surgery for intermittent exotropia can alter refractive astigmatism and cause a myopic shift in children. Astigmatism changes typically occur within 3 months post-surgery and warrant monitoring.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Intermittent exotropia is a common childhood strabismus.
- Surgical correction of horizontal rectus muscles is a standard treatment.
- The impact of this surgery on refractive astigmatism requires further investigation.
Purpose of the Study:
- To evaluate changes in refractive astigmatism following horizontal rectus muscle surgery in children with intermittent exotropia.
- To compare astigmatism changes between unilateral lateral rectus recession and combined recession-resection procedures.
Main Methods:
- Retrospective review of 69 exotropic patients.
- Categorization into bilateral lateral rectus recession (BLR) and recession-resection (R&R) groups.
- Non-cycloplegic refractions analyzed for spherical equivalent (SE), J0, and J45 up to 6 months post-op.
Main Results:
- Both surgical groups showed a significant myopic shift in SE within the first week, which stabilized thereafter.
- Astigmatism (J0) changed significantly in both groups, with changes noted within the first 3 months.
- No significant changes in J45 were observed, and no significant differences in SE, J0, or J45 changes were found between the BLR and R&R groups at 6 months.
Conclusions:
- Horizontal rectus muscle surgery in intermittent exotropic children can induce with-the-rule astigmatism and a myopic shift.
- These refractive changes appear within the first 3 months post-surgery.
- Regular monitoring and correction of astigmatism are recommended at least 3 months after strabismus surgery.
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