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Retinal perforation in strabismus surgery

L P Noel1, J N Bloom, W N Clarke

  • 1Children's Hospital of Eastern Ontario, Department of Ophthalmology, Canada.

Journal of Pediatric Ophthalmology and Strabismus
|March 1, 1997
PubMed
Summary
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Retinal perforation occurred in 0.4% of pediatric strabismus surgeries, with choroidal injury in 1.4%. No retinal detachments or infections were observed in this study of horizontal muscle surgery complications.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Ocular Trauma

Background:

  • Retinal perforation is a significant complication associated with strabismus surgery.
  • Previous studies report a wide incidence range for retinal perforation, from 0.13% to 12%.

Purpose of the Study:

  • To determine the incidence of suspected and unsuspected retinal and choroidal injury during pediatric horizontal muscle surgery.
  • To analyze data from a large collaborative database to assess complication rates.

Main Methods:

  • A retrospective analysis of 765 children undergoing horizontal strabismus surgery between September 1992 and October 1995.
  • Indirect ophthalmoscopy was performed immediately post-surgery for all patients.
  • Exclusion criteria included muscle reoperation, high myopia, and connective tissue disorders.

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Main Results:

  • A total of 1129 muscle recessions, 349 muscle resections, and 161 vertical/oblique muscle procedures were performed.
  • Intraocular trauma was observed in 14 patients (1.8%), including three cases of retinal perforation (0.4%).
  • Choroidal injury without perforation was noted in 1.4% of cases.

Conclusions:

  • The incidence of retinal perforation in pediatric horizontal strabismus surgery is 0.4%.
  • The incidence of choroidal injury without perforation is 1.4%.
  • No cases of retinal detachment or endophthalmitis were reported within the 6-week follow-up period.