Outcomes of Squint Surgery in Terms of Motor Alignment within 10 Prism Diopters in a Tertiary Care Hospital: A Clinical Audit

Purpose: To determine the outcome of squint surgery in terms of motor ocular alignment within 10 prism diopters, in a tertiary care hospital. Study Design: A clinical audit at a tertiary care hospital. Place and Duration of Study: The study was conducted in Ophthalmology department, of Aga khan university hospital, Karachi between December 2016 and June 2017. Methods: Medical records of all patients who underwent squint surgery were retrieved and included in the study. Patients with amblyopia, corneal or retinal pathologies and those who lost to follow-up or with incomplete records were excluded. All the available demographic and clinical data including pre-operative visual acuity, squint measurements, procedure performed and post-operative ocular alignment up to maximum of 6 months of follow-up was compiled. Results: One hundred and nineteen patients fulfilled the inclusion criteria. There were 54.6% males and 45.4% were females. Squint was unilateral in 75.4% of patients and bilateral in 24.5%. Exotropia was present in 74 (62%) and Esotropia in 45 (38%) patients. The frequency of post-operative outcomes among the study participants were analyzed and it was reported that at six months follow-up central straight eye position or squint less than 10 prism diopters was seen among 75.5% of patients. The association of age and gender with primary outcome was obtained by applying independent sample T test. All the categories of age and gender showed statistically significant results i.e. p-value ? 0.05, except one week follow-up among different categories of gender showing insignificant results with p value = 0.740. Conclusion: In present study 75.5% patients achieved the required result of ocular alignment within 10 prism diopters of orthotropia at the final follow-up visit. Key Words: Squint, Esotropia, Exotropia, 10 prism Diopters.

Accuracy of anterior segment optical coherence tomography for pre-operative localization of insertions of extraocular recti muscles

Introduction: To study the accuracy of anterior segment optical coherence tomography (AS-OCT) function of Cirrus HD-OCT 500 (Carl Zeiss Meditec, Dublin, CA) in calculating the insertion of rectus muscles from the limbus in patients undergoing primary squint surgery. Methodology: A prospective, double-masked, observational study was conducted on 128 muscles of 46 patients with strabismus who were planned for strabismus surgery between January 2019 and December 2019. Insertion distance from limbus was measured using AS-OCT function of Cirrus HD-OCT 500 preoperatively. Intraoperative measurements were taken using Castroviejo caliper. A Bland-Altman analysis was performed to determine the agreement between the readings. Results: A total of 128 muscles were successfully imaged and evaluated, including 13 superior recti (10.15%), 23 inferior recti (17.96%), 35 medial recti (27.34%) and 57 lateral recti (44.53%). 124 muscles (96.9%) were within 1mm difference, which was considered clinically acceptable. Bland-Altman plots showed the level of agreement between the two methods was good. Conclusion: Anterior segment scan function of Cirrus HD-OCT 500 is an accurate method to detect the insertion of extraocular recti muscles in patients of primary strabismus surgery.

Ophthalmology surgery

This chapter describes anaesthesia for paediatric ophthalmic cases. Management is generally straightforward, but is not without its problems and complications. Most procedures are day cases, but they may involve children who are unable to comply with tests when awake, children having multiple procedures, or syndromes associated with their ophthalmic condition. Ages range from the neonate to teenagers and involve procedures such as examination under anaesthesia (EUA), squint surgery, cataract surgery (and its complications), nasolacrimal surgery, oculoplastic surgery, and glaucoma surgery. The side effects of ocular drops are discussed, as are the risks of surgery in and around the eye, e.g. the oculocardiac reflex. Also covered are emergencies such as ‘the penetrating eye injury’ scenario.

The Presentation of Misaligned Eyes in Children with Pervious Squint Surgery at Tripoli Eye Hospital

Strabismus, is one of the most common ocular problems in children. It can be treated with conservative therapy such as glasses, prisms, patching and/or orthoptic exercises, with a majority of the cases eventually requiring correction with eye muscle surgery. The benefits of surgical correction include elimination of diplopia, restoration of binocular single vision, and improvement of cosmesis and psychosocial status. However, some reports in the past two decades have indicated the possibility of good surgical outcomes, and significant improvements of central and peripheral binocular visual function even in adult patients. The aim of this present study is to determine the prevalence of squinted eyes with previous squint surgery in patients attend the squint outpatient clinic.

The Presentation of Misaligned Eyes in Children with Pervious Squint Surgery at Tripoli Eye Hospital

Strabismus, is one of the most common ocular problems in children. It can be treated with conservative therapy such as glasses, prisms, patching and/or orthoptic exercises, with a majority of the cases eventually requiring correction with eye muscle surgery. The benefits of surgical correction include elimination of diplopia, restoration of binocular single vision, and improvement of cosmesis and psychosocial status. However, some reports in the past two decades have indicated the possibility of good surgical outcomes, and significant improvements of central and peripheral binocular visual function even in adult patients. The aim of this present study is to determine the prevalence of squinted eyes with previous squint surgery in patients attend the squint outpatient clinic.