Transient Increase of Wavefront Aberrations after Horizontal Rectus Muscle Surgery in Exotropia

Aims: Wavefront aberration (WA) has become one of the important indicators for measuring the visual quality. Whether strabismus surgery affects the WA remain controversial. This study aims to investigate the postoperative alterations of WA in patients who underwent horizontal rectus muscle surgery.Methods: A total of 34 patients were enrolled and divided into two groups: bilateral lateral rectus recession (BLR) group and unilateral lateral rectus recession and medial rectus resection (R&R) group. The WA was examined 1 day before surgery, 3 days, and 6 weeks after surgery using the iTrace Visual Function Analyzer (Tracey Technologies).Results: Significant increases in total WA, lower-order aberration (LOA) and higher-order aberration (HOA) of both groups were detected in 3 days after surgery (P < 0.05), while no significant differences in 6 weeks after surgery. Significant increases in astigmatism, secondary astigmatism, and trefoil of both groups were detected in 3 days after surgery (P < 0.05), while no significant differences in individual order of LOA and HOA in 6 weeks postoperatively. Z₂², Z₃³, and Z₄² of both groups increased significantly 3 days after surgery (P < 0.05) and returned to baseline level 6 weeks after surgery, while the rest Zernike coefficients remained the same postoperatively. When comparing the differences between the two groups, there were no statistically significant differences in these parameters between baseline and each follow-up visit postoperatively.Conclusions: The increase of WA restored to pre-operative level in 6 weeks after surgery, indicating the influences of horizontal rectus muscle surgery to WA were transient and reversible.