Preservation and observation of anterior ciliary vessels in rectus muscles during strabismus surgery

To observe the form and number of the anterior ciliary vessels (ACV) in rectus muscles. To train technician in preservation and observation of ACV, so preservation can be done in cases with a risk of anterior segment ischemia (ASI).

Curved foreign knife, iris hook, plastic rubber band and standard operating loupes (3x.) or microscope were used in the surgery on 34 cases of comitant strabismus and 18 cases of paralytic strabismus.

The ACVs per muscle in medial, lateral, superior, inferior rectus were 3.08, 3.26, 3.50 and 3.50 respectively in 89 muscles of 52 surgical strabismus cases. All ACVs in 16 rectus muscles and 90 out of 220 ACVs in 73 rectus muscles were too small or too short to be dissected. The success rate of ACV preservation was 91.5% (119/130). 105 out of 130 vessels were saved using loupe magnification and 14 pit pf 130 vessels were saved under operating microscope.

The number of ACV in rectus muscles are more than 2 in our observation cases. The ACV preservation has the clinical value of allowing us to perform muscle surgery on three or more rectus muscles simultaneously and get final surgical results more earlier after ACV in each muscle are dissected and preserved otherwise staged surgery are needed. The each strabismus surgeon must know this technique.