Our Summary

This research paper is about a study conducted on patients who have a specific type of nerve damage called chronic sixth nerve palsy (CSNP). This condition can cause issues with eye movement, specifically a disorder called strabismus, where the eyes don’t look in the same direction at the same time. The researchers looked at various surgeries that are used to treat this condition, and tracked how successful they were.

The study looked at 55 patients who had undergone surgery between 2015 and 2019 in a hospital in Saudi Arabia. The researchers defined success as the eyes deviating less than or equal to 10 prism diopters (a measurement unit for eye deviation) a year after the surgery. They found that about 67% of the surgeries were successful.

The study also found that the type of surgery did not affect the success rate. Instead, the factors that made a difference were whether the condition affected both eyes, how severe the deviation was before surgery, and how limited the eye movement was before surgery. The more severe these factors were, the less likely the surgery was to succeed.

The researchers concluded that the severity of the condition before surgery may affect the chances of success and whether or not a second surgery is required. They recommend that patients with severe CSNP be informed about their likelihood of needing additional surgeries and the potential success rate.

FAQs

  1. What is chronic sixth nerve palsy (CSNP) and how does it relate to strabismus?
  2. What factors were found to affect the success rate of strabismus surgery in the study?
  3. What is the recommended approach for patients with severe CSNP based on the study’s findings?

Doctor’s Tip

A doctor might tell a patient considering strabismus surgery that the success of the surgery can be impacted by the severity of the condition before the surgery. It is important to discuss with your doctor about the likelihood of needing additional surgeries and the potential success rate based on your specific case. Additionally, factors such as whether the condition affects both eyes and the limited eye movement before surgery can also play a role in the success of the surgery. It is important to have realistic expectations and discuss all options with your doctor before moving forward with the surgery.

Suitable For

In general, patients who are recommended strabismus surgery are those who have persistent misalignment of the eyes that cannot be corrected with non-surgical methods such as glasses, patches, or vision therapy. Some common types of patients who may be recommended for strabismus surgery include:

  1. Children with early-onset strabismus: Children who develop strabismus at a young age may be recommended for surgery to prevent long-term vision problems and improve eye alignment.

  2. Adults with long-standing strabismus: Adults who have had strabismus since childhood or have developed it later in life may be recommended for surgery to improve eye alignment and correct double vision.

  3. Patients with neurological conditions: Patients with conditions such as cerebral palsy, stroke, or traumatic brain injury that affect the nerves and muscles controlling eye movement may be recommended for surgery to improve eye alignment and function.

  4. Patients with chronic sixth nerve palsy: Patients with chronic sixth nerve palsy, as discussed in the research paper, may be recommended for surgery to improve eye alignment and reduce eye deviation.

Overall, the decision to recommend strabismus surgery is based on factors such as the severity of the eye misalignment, the presence of underlying medical conditions, and the potential benefits of surgery in improving eye alignment and function. Patients should consult with an ophthalmologist or strabismus specialist to determine if surgery is the best treatment option for their specific case.

Timeline

Before strabismus surgery:

  • Patient experiences symptoms such as misaligned eyes, double vision, or difficulty focusing
  • Patient may undergo various tests and examinations to determine the cause and severity of the strabismus
  • Patient may try non-surgical treatments such as vision therapy, prism glasses, or botox injections
  • Patient consults with an ophthalmologist or strabismus specialist to discuss surgical options

After strabismus surgery:

  • Patient undergoes the surgical procedure to correct the misalignment of the eyes
  • Patient may experience some discomfort, swelling, or redness in the eyes after surgery
  • Patient may need to wear an eye patch or protective shield for a period of time
  • Patient attends follow-up appointments with the surgeon to monitor progress and adjust treatment as needed
  • Patient may need to undergo additional surgeries or treatments if the initial surgery is not successful
  • Patient may experience improved eye alignment, vision, and overall quality of life after successful surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery?
  2. How long is the recovery period after strabismus surgery?
  3. How many surgeries might be needed to fully correct the strabismus?
  4. What are the chances of the strabismus returning after surgery?
  5. What alternative treatment options are available for strabismus?
  6. How soon after surgery can I expect to see improvements in my eye alignment?
  7. Will I need to wear an eye patch or use eye drops after surgery?
  8. How will strabismus surgery impact my daily activities and lifestyle?
  9. Are there any specific post-operative care instructions I should follow?
  10. What is the success rate of strabismus surgery in patients with my specific condition and severity?

Reference

Authors: Alghofaili RS, Sesma G, Khandekar R. Journal: Middle East Afr J Ophthalmol. 2021 Sep 25;28(2):104-110. doi: 10.4103/meajo.meajo_510_20. eCollection 2021 Apr-Jun. PMID: 34759668