Our Summary

This research paper discusses a surgical method for treating strabismus, a condition where the eyes don’t look in exactly the same direction at the same time. It can be challenging to manage patients with mild to moderate cases of this condition. The paper focuses on one-muscle surgery, a procedure where only one eye muscle is operated on. This method has been controversial because of worries it might not fully correct the eye misalignment or could cause other eye issues. However, recent research has shown that one-muscle surgery is a safe and effective treatment for mild to moderate strabismus. It has benefits like reducing the operation time and cost, and leaves other eye muscles untouched if additional surgery is needed. The paper suggests that larger studies should be conducted in the future, but recommends considering one-muscle surgery as a primary treatment for mild to moderate strabismus.

FAQs

  1. What is the controversy surrounding one-muscle surgery for comitant strabismus?
  2. What are the benefits of unilateral rectus muscle surgery for small to moderate horizontal deviations?
  3. Is unilateral rectus muscle surgery considered a primary approach in the treatment of small to moderate angle esotropia?

Doctor’s Tip

A doctor might tell a patient considering strabismus surgery that one-muscle surgery for small to moderate angle horizontal deviations can be a safe and effective option. This type of surgery limits the procedure to one eye, reduces operative time and cost, and leaves other muscles untouched in case additional surgery is needed in the future. It is important to discuss all options and potential outcomes with your doctor before making a decision.

Suitable For

Patients with small to moderate angle esotropia are typically recommended for strabismus surgery, particularly those who have not responded well to other forms of treatment such as glasses or vision therapy. The use of unilateral rectus muscle surgery has been shown to be a safe and effective procedure for these patients, offering advantages such as reduced operative time and cost to the family. Larger studies are needed in the future to further evaluate the effectiveness of this approach, but it should be considered as a primary treatment option for patients with small to moderate angle esotropia.

Timeline

Before strabismus surgery:

  • Patient undergoes a thorough eye examination by an ophthalmologist to determine the type and severity of the strabismus.
  • Patient may undergo vision testing, eye muscle testing, and imaging studies such as MRI or CT scans.
  • Patient and surgeon discuss treatment options, risks, and benefits of surgery.
  • Patient may need to undergo pre-operative testing and evaluations to ensure they are healthy enough for surgery.

After strabismus surgery:

  • Patient is monitored closely in the recovery room for any immediate complications.
  • Patient may experience some discomfort, redness, and swelling in the eyes following surgery.
  • Patient may need to wear an eye patch or protective shield for a period of time.
  • Patient may be prescribed eye drops or ointments to prevent infection and aid in healing.
  • Patient will have follow-up appointments with the surgeon to monitor progress and make any necessary adjustments to the treatment plan.
  • Patient may need to undergo vision therapy or other treatments to help improve eye alignment and coordination.
  • Patient may experience improved vision, depth perception, and overall quality of life as a result of successful strabismus surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery?
  2. What is the success rate of strabismus surgery in correcting my specific type and degree of strabismus?
  3. How long is the recovery period after strabismus surgery and what can I expect during this time?
  4. Will I need to wear glasses or use any other tools after the surgery to help maintain proper alignment of my eyes?
  5. Are there any alternative treatment options to consider before moving forward with surgery?
  6. How many strabismus surgeries have you performed and what is your success rate?
  7. How will the surgery affect my vision and overall eye health in the long term?
  8. What type of anesthesia will be used during the surgery and what are the potential risks associated with it?
  9. Will I need to follow up with regular appointments or additional treatments after the surgery?
  10. Are there any specific lifestyle changes or precautions I should take before or after the surgery to ensure the best possible outcome?

Reference

Authors: Gurland J, Vagge A, Nelson LB. Journal: J Pediatr Ophthalmol Strabismus. 2018 Sep 20;55(5):288-292. doi: 10.3928/01913913-20180327-03. Epub 2018 Jun 19. PMID: 29913025