Improved Strabismus Surgical Outcomes with a New Table
Abstract
Purpose: To find out the most scientific formula for strabismus surgery.
Patients and method: 84 subjects having normal eyes ranging from 3 years of age to 48 years over 4 years from 2011 to 2015 were photographed by iPhone with flash to locate reflex of the light on a part of eye, while 6 extra ocular muscles moved the eye to the extremes, in the direction of their action. The distance of the reflex was measured from center of the pupil. The diameter of the cornea was measured from white to white by caliper. Pupil diameter was also measured in every case. Each mm of reflex away from the center of the pupil is equal to 15 prism diopter (PD)1 . So the total deviation of eye at extreme action of a particular muscle is measured and converted to PD. Each extraocular muscle has different length.
Assumption: The length of the muscle is responsible for total deviation of the eye by full action of the muscle. Then the surgical table was applied to surgically correct 84 eyes having, either esotropia or exotropia.
Results: 1 mm of resection or recession of Lateral Rectus (LR) corrects 5PD.Similarly, 1mm of either recession or resection of Medial Rectus (MR), Superior Rectus (SR), Inferior Rectus (IR) and Superior Oblique (SO) corrects 2.5PD. 1mm of recession or resection of Inferior Oblique (IO) corrects 4PD.This finding is statistically significant and p value less than 0.05.
Conclusion: The strabismus surgical table created by the author is accurate as verified by strabismus operations over 4 years.
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Introduction
Many strabismus surgical tables were proposed by erudite authors of strabismology in different established journals and also faithfully followed all over the world. These tables are empirical, rather than scientific. So, dissatisfactory outcome and reoperation are being done to correct the strabismus.
First a strabismus surgical table was invented in this article and then applied to surgical correction of eyes having either an esotropia or an exotropia.
The success of the operation made the hypothesis a thesis.
Conclusion
1mm of either recession or resection of lateral rectus corrects 5PD of strabismus. But resection and recession of medial rectus, superior rectus, inferior rectus and superior oblique corrects 2.5PD of strabismus. 1mm of recession and resection of inferior oblique corrects 4PD of strabismus.