Our Summary

This study looked at the long-term results of eye muscle surgery in patients with third nerve palsy, a condition where damage to the third cranial nerve causes issues with eye movement and eyelid opening. The researchers reviewed medical records from the past 15 years, looking at things like how the patient’s eye position changed over time, what kind of surgery was done, and what factors might predict how well the surgery worked.

They found that surgery was done in 31 cases. The average age was 36 years (just over half were women), and most of the patients had acquired their palsy rather than being born with it. Before surgery, the average horizontal and vertical deviations (how much the eye was out of alignment) were quite high, but these reduced significantly after surgery.

Most of the patients had only one surgery. The surgery was considered a cosmetic success (the eyes looked aligned) in about 65% of the cases, and a functional success (the patient didn’t see double images) in about 72% of the cases. Interestingly, the researchers found that the alignment of the eyes continued to improve over time, even a year after the surgery.

However, they couldn’t identify any specific factors that could predict whether the surgery would be successful or not. The researchers concluded that the cosmetic and functional results were similar, and that eye alignment typically improved over time after the surgery.

FAQs

  1. What is third nerve palsy and how does it affect the eyes?
  2. What were the key findings of the study on the effects of eye muscle surgery on patients with third nerve palsy?
  3. Could the researchers identify any factors that could predict the success of the surgery for third nerve palsy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about strabismus surgery is to follow post-operative instructions carefully, including any eye exercises or medications prescribed. It’s important to attend all follow-up appointments to monitor progress and address any concerns. Additionally, be patient and give your eyes time to heal and adjust to the surgery, as improvements may continue over time. Lastly, maintain good eye health habits, such as wearing prescribed glasses or contacts and protecting your eyes from injury.

Suitable For

Overall, patients with third nerve palsy who have significant horizontal and vertical deviations in eye alignment are typically recommended for strabismus surgery. The surgery is often considered successful in improving both the cosmetic appearance of the eyes and reducing double vision in these patients. While there may not be specific factors that predict the success of the surgery, the study suggests that patients can expect continued improvement in eye alignment even after the surgery.

Timeline

Overall, the timeline of a patient’s experience before and after strabismus surgery may look something like this:

Before surgery:

  • Patient notices misalignment of the eyes
  • Patient visits an eye care professional for a comprehensive eye exam
  • Diagnosis of strabismus is made
  • Discussion with the eye care professional about treatment options, including surgery
  • Pre-operative appointments and tests are scheduled
  • Patient undergoes strabismus surgery

After surgery:

  • Patient may experience discomfort or pain in the eye(s) following surgery
  • Patient may have to wear an eye patch or protective shield for a period of time
  • Follow-up appointments with the eye care professional to monitor healing and eye alignment
  • Patient may need to do eye exercises or vision therapy to improve eye muscle strength and coordination
  • Improvement in eye alignment and reduction in double vision may be seen over time
  • Long-term follow-up appointments to monitor the success of the surgery and address any recurrence of strabismus

Overall, the timeline of a patient’s experience before and after strabismus surgery can vary depending on the individual case, but the goal is to improve eye alignment, reduce double vision, and ultimately improve the patient’s quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about strabismus surgery based on this study include:

  1. What is the average age of patients who undergo strabismus surgery, and how does age impact the success of the surgery?
  2. What are the typical horizontal and vertical deviations before and after surgery, and how much improvement can I expect?
  3. How many surgeries are usually needed to correct strabismus, and what factors determine the success of the surgery?
  4. What are the differences between cosmetic success (alignment of the eyes) and functional success (elimination of double vision), and how likely am I to achieve both?
  5. How long does it typically take for eye alignment to improve after surgery, and are there any factors that can predict the long-term results?
  6. Are there any potential risks or complications associated with strabismus surgery, and how can they be minimized?
  7. What is the recovery process like after surgery, and what kind of follow-up care will be needed?
  8. Are there any alternative treatments or therapies for strabismus that I should consider before opting for surgery?
  9. How experienced are you in performing strabismus surgery, and what is your success rate with similar cases?
  10. Can you provide me with any patient testimonials or references from previous strabismus surgery patients to help me make an informed decision?

Reference

Authors: Merino P, Gutierrez C, de Liaño PG, Srur M. Journal: J Optom. 2019 Jul-Sep;12(3):186-191. doi: 10.1016/j.optom.2018.10.004. Epub 2019 Jan 4. PMID: 30600170