Refractive changes after strabismus surgery in patients with intermittent exotropia

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Refractive Error

Background:

• Intermittent exotropia is a common strabismus condition.
• Horizontal muscle surgery is a primary treatment for intermittent exotropia.
• Long-term refractive changes after such surgery require evaluation.

Purpose of the Study:

• To assess long-term refractive changes following horizontal muscle surgery in intermittent exotropia patients.
• To identify correlations between refractive error changes and clinical factors.

Main Methods:

• Retrospective review of patients under 15 undergoing unilateral strabismus surgery.
• Recording refractive errors preoperatively and up to four years postoperatively.
• Utilizing a mixed model to compare operated and fellow eyes and analyze influencing factors.

Main Results:

• No significant difference in spherical equivalent change between eyes post-surgery.
• Operated eyes showed a sustained, significant increase in with-the-rule astigmatism (0.25D).
• Surgical technique impacted astigmatism changes, with lateral rectus recession and medial rectus plication (RP) showing less effect than lateral rectus recession and medial rectus resection (RR) or lateral rectus recession alone (LRc).

Conclusions:

• Horizontal muscle surgery does not induce long-term spherical refractive error changes.
• Mild with-the-rule astigmatism is a sustained postoperative outcome.
• The type of horizontal muscle surgery influences the degree of induced astigmatism.