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Extraocular muscle resection, recession length and surgery outcome modelling in strabismus treatment: a pilot study
Ala Paduca1,2, Oleg Arnaut3, Eugeniu Bendelic2
1Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.
Background:
Many surgical formulas have been developed and proposed based on the experience of surgeons to improve the predictability of strabismus surgery. However, the consent among strabismus surgeons regarding the dose effect of the extraocular muscle (EOM) recession or resection was not achieved yet and the disagreement about the appropriate amount of strabismus surgery still exists.
Objective:
Our study aimed to propose an instrument for EOM resection (RsL) and recession length (RcL) estimation before the surgery and second to elaborate an postoperative angle of deviation (PAD) predictive model using simple potential predictors.
Methods And Analysis:
The analytical prospective clinical study was conducted from April 2016 to July 2019, on a sample of 216 patients (aged between 2-58) with concomitant strabismus who underwent strabismus surgery in Clinical Republican Hospital 'Timofei Mosneaga'and Children Hospital 'Em Cotaga' from Republic of Moldova. The correlations of patients' age, strabismus type, amblyopia degree, RsL, RcL, preoperative angle of deviation (PreAD) with PAD were estimated using Pearson's correlation analysis. Multiple linear regression analysis, multicollinearity analysis and residual analysis were performed.
Results:
The EOM RsL was predicted using strabismus type, patient's age, PreAD and EOM RcL. EOM RcL, in turn, was estimated by the similar covariates set, instead of RcL being RsL. PAD modelling showed the PreAD, EOM RsL and EOM RcL predictive ability for strabismus surgery outcome prediction.
Conclusion:
In our study, we propose four mathematical models as potential instruments for EOM RsL, EOM RcL and PAD modelling in esotropia and exotropia surgery.
Insights
This study introduces new mathematical models to predict extraocular muscle (EOM) resection and recession lengths, improving strabismus surgery outcomes. The models help estimate postoperative deviation, enhancing surgical planning for strabismus patients.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Clinical Research
Background:
- Existing strabismus surgery formulas lack surgeon consensus.
- Disagreement persists regarding optimal extraocular muscle (EOM) recession or resection amounts.
- Predictability of strabismus surgery outcomes remains a challenge.
Purpose of the Study:
- To propose an instrument for estimating EOM resection length (RsL) and recession length (RcL) before strabismus surgery.
- To develop a predictive model for postoperative angle of deviation (PAD) using simple predictors.
- To enhance the precision of strabismus surgical planning.
Main Methods:
- An analytical prospective clinical study involving 216 patients with concomitant strabismus.
- Correlation analysis (Pearson) to assess relationships between age, strabismus type, amblyopia, RsL, RcL, preoperative angle of deviation (PreAD), and PAD.
- Multiple linear regression, multicollinearity, and residual analyses were performed.
Main Results:
- EOM RsL was predicted using strabismus type, patient's age, PreAD, and EOM RcL.
- EOM RcL was estimated using a similar set of covariates.
- PreAD, EOM RsL, and EOM RcL demonstrated predictive ability for strabismus surgery outcomes (PAD).
Conclusions:
- Four mathematical models were proposed for EOM RsL, EOM RcL, and PAD modeling.
- These models serve as potential instruments for optimizing strabismus surgery.
- The study contributes to improved predictability in esotropia and exotropia surgery.
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