Our Summary

The research paper is about a study conducted on a new surgical technique for treating strabismus, a condition where the eyes do not properly align with each other when looking at an object. This new technique, called minimally invasive strabismus surgery (MISS), was tested on 26 patients at a hospital over a four-year period.

The results showed that the MISS technique was effective in treating strabismus. The surgery involved making small adjustments to the muscles in the eyes, either by moving them back (recession), cutting a part of them (resection), or folding them (plication).

After the surgery, the patients’ vision did not significantly change, indicating that the surgical procedure did not negatively impact their eyesight. Some patients experienced mild to moderate inflammation in their eyes, but this was temporary and subsided within a few days after the surgery.

There were a few complications such as bleeding during the surgery, a puncture in the eye, and a part of the eye tissue coming out. However, these were rare instances and were managed effectively.

One patient had to undergo a different surgical procedure because the surgeons couldn’t see properly during the MISS technique.

The time it took to perform the surgery decreased over the four-year period, showing that the surgeons became more efficient with experience.

In conclusion, the MISS technique shows promise as a good way to treat strabismus. It is minimally invasive, doesn’t negatively impact vision, and the surgeons can become adept at it over time.

FAQs

  1. What is the minimally invasive strabismus surgery (MISS) technique?
  2. What were the outcomes of the MISS technique in treating horizontal strabismus?
  3. Were there any complications observed with the MISS technique?

Doctor’s Tip

A helpful tip a doctor might tell a patient about strabismus surgery is to follow post-operative care instructions carefully to ensure optimal healing and outcomes. This may include using prescribed eye drops, avoiding rubbing or putting pressure on the eyes, and attending follow-up appointments as scheduled. It is also important to communicate any concerns or changes in vision to your doctor promptly.

Suitable For

Patients with horizontal deviation, such as esotropia or exotropia, are typically recommended for strabismus surgery. The study mentioned in the abstract specifically focused on horizontal strabismus surgery using the minimally invasive strabismus surgery (MISS) technique. The patients included in the study were children with a mean age of 7.7 years old, and the surgery involved operating on the medial and lateral recti muscles through recessions, resections, and plications.

Overall, the study found that the MISS technique resulted in good outcomes for horizontal strabismus surgery, with stable visual acuity and a decrease in operating time after a 4-year learning curve. Common complications observed included conjunctival inflammation and rare occurrences of intraoperative complications such as conjunctival haemorrhages, scleral perforation, and Tenon’s prolapses. In some cases, a conversion from MISS to a fornix approach was necessary for better visualization during surgery.

Timeline

Before strabismus surgery:

  • Patient presents with symptoms of misaligned eyes
  • Consultation with an ophthalmologist for evaluation
  • Discussion of treatment options, including minimally invasive strabismus surgery
  • Pre-operative assessment and testing
  • Consent for surgery

After strabismus surgery:

  • Patient undergoes minimally invasive strabismus surgery
  • Postoperative care and monitoring for complications
  • Mild to moderate hyperaemia observed in the days following surgery
  • Visual acuity remains stable at postoperative day 1 and 6 months after surgery
  • Complications such as conjunctival haemorrhage, scleral perforation, and Tenon’s prolapse may occur
  • In some cases, conversion to a fornix approach may be necessary
  • Operating time decreases after a learning curve
  • Follow-up appointments to monitor progress and adjust treatment as needed.

What to Ask Your Doctor

  1. What is the success rate of minimally invasive strabismus surgery for treating horizontal deviation?

  2. What are the potential risks and complications associated with this type of surgery?

  3. How long is the recovery period after minimally invasive strabismus surgery?

  4. How many surgeries have you performed using the minimally invasive technique?

  5. Will I need to wear an eye patch or have any restrictions after the surgery?

  6. What is the expected outcome in terms of improved eye alignment after the surgery?

  7. How long do the effects of the surgery typically last?

  8. Are there any alternative treatment options for my condition?

  9. What can I expect in terms of post-operative care and follow-up appointments?

  10. Are there any specific activities or behaviors I should avoid after the surgery to ensure successful results?

Reference

Authors: Merino P, Blanco Domínguez I, Gómez de Liaño P. Journal: Arch Soc Esp Oftalmol. 2016 Feb;91(2):69-73. doi: 10.1016/j.oftal.2015.11.002. Epub 2015 Dec 22. PMID: 26706777