Plication as an alternative to resection in horizontal strabismus: A randomized clinical trial

Area of Science:

• Ophthalmology
• Surgical Techniques
• Strabismus Management

Background:

• Horizontal strabismus surgery aims to realign the eyes.
• Muscle resection and plication are surgical techniques used to correct strabismus.
• Plication offers potential advantages like being less traumatic and vascularity preserving.

Purpose of the Study:

• To compare inflammation, scarring, and alignment outcomes between uniocular recession and resection (R&R) and uniocular recession and plication (R&P) for horizontal strabismus.
• To evaluate the efficacy and safety of plication versus resection in strabismus surgery.

Main Methods:

• A prospective, patient and assessor-blind, randomized trial was conducted.
• Patients with horizontal strabismus underwent either R&R or R&P surgery.
• Outcomes measured included inflammatory grades, scar visibility (SV), and successful alignment (≤10 prism diopters).

Main Results:

• Forty patients were randomized (22 R&R, 18 R&P), with comparable baseline characteristics.
• No significant differences were found in total inflammatory scores (TIS) between the groups (P > 0.05).
• Scar visibility (P=0.19) and successful alignment rates (P=0.74) were also comparable between R&R and R&P.

Conclusions:

• Plication, when combined with recession, is as effective as resection in correcting horizontal strabismus.
• The study suggests that plication should be considered more frequently due to its comparable efficacy and potentially less invasive nature.