Ophthalmology in China

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Analysis of short-term refractive status changes after strabismus surgery and its influence factors

ZHAO Bo-wen, FU Jing, ZHOU Jin-qiong, QI Meng, WANG Jing-hui, SUN Xing-li   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
  • Received:2019-03-06 Online:2019-09-25 Published:2019-09-24
  • Contact: FU Jing, Email: fu_jing@126.com

Abstract:

Objective To investigate changes in best corrected visual acuity (BCVA) and refractive status short-term after strabismus surgery. Design Prospective clinical study. Participants 321 cases (475 eyes) were collected from December 16, 2013 to August 31, 2017 in Beijing Tongren hospital with a mean ageof 12.2±15.1 years (range 3-58). Methods All surgery eyes were divided into five groups: Group 1 had one rectus recession; Group 2 had one rectus recession combined with rectus resection on the antagonistic muscle; Group 3 had one rectus recession combined with improved rectus linear tucking on the antagonistic muscle; Group 4 had one rectus recession combined with one oblique recession and Group 5 had two rectus combined with one oblique recession. Main Outcome Measures The BCVA and refractive status before surgery and 1 months after surgery (Patients under 12 years old were done under ciliary muscle paralysis). Results There were no significant differences in preoperative BCVA, spherical equivalent (SE), or astigmatism among the five groups (P=0.75, 0.56, 0.39). There were no significant differences in BCVA among the five groups at one months(P=0.29). There were no significant differences in BCVA before and 1month after surgery. There were no significant differences in SE before and 1month after surgery in group 1-4. In group 5, SE significantly decreased after surgery, from -0.67±2.34 D to -1.09±1.16 D. Before surgery astigmatism in group 1 was 0.52±0.83 D, in group 2 was 0.74±0.52 D, in group 3 was 0.73±1.19 D, in group 4 was 0.61±1.67 D, in group 5 was 0.71±1.41 D. 1 month after surgery astigmatism in group 1 was 0.81±0.88 D, in group 2 was 1.12±1.55 D, in group 3 was 1.14±2.30 D, in group 4 was 1.06±1.69 D and in group 5 was 1.39±2.05 D, The astigmatism increased at one months in all groups compared to preoperative levels (all P<0.01). Conclusion The strabismus surgery increases astigmatism in early stage. Increased number of operated muscles may lead to more spherical equivalent and astigmatism diopter change. (Ophthalmol CHN, 2019, 28: 368-371)

Key words: strabismus/surgery, visual acuity, spherical equivalent, astigmatism