Our Summary

This research paper analyzed a large group of eye surgeries, specifically vitreoretinal surgeries, to see how often they led to strabismus, a condition that causes the eyes to not line up with each other. The surgeries took place in a practice that also had the only adult strabismus surgeon in the area. The researchers focused on instances where further surgery was required to correct the strabismus, as these cases were likely more severe. Out of 4,176 surgeries, they found that 7 cases (or 0.17%) led to strabismus that required further surgery. This included one patient who had a history of strabismus surgery, two patients who had a specific type of operation called a scleral buckle, and two patients who developed strabismus in a way that is typically associated with the local anesthesia used in the surgery.

FAQs

  1. What is strabismus and what causes it after intraocular surgery?
  2. How common is strabismus after vitreoretinal surgeries?
  3. What is the difference between surgical and non-surgical management of postoperative strabismus?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to follow postoperative instructions carefully, including any prescribed eye exercises or vision therapy. It is important to attend all follow-up appointments with your eye doctor to monitor progress and address any concerns. Additionally, it is important to communicate any changes in vision or eye alignment to your doctor promptly to ensure optimal results from the surgery.

Suitable For

Patients who are typically recommended strabismus surgery following other intraocular surgeries, such as vitreoretinal surgeries, may have risk factors such as retrobulbar anesthesia and exoplants. In the cohort studied, there were 7 cases of strabismus surgery following 4,176 retina surgeries, with some patients having a prior history of strabismus surgery or a course consistent with typical block infiltration strabismus. These patients may benefit from strabismus surgery to correct their misalignment of the eyes and improve their visual function.

Timeline

Before strabismus surgery:

  1. Patient notices misalignment of the eyes, which may be present since childhood or develop later in life.
  2. Patient undergoes a comprehensive eye examination by an ophthalmologist to diagnose strabismus and determine the severity of misalignment.
  3. Treatment options such as glasses, eye exercises, or prism therapy may be prescribed to manage the condition.
  4. If conservative treatments are ineffective, the patient may be referred to a strabismus surgeon for surgical intervention.

After strabismus surgery:

  1. Patient undergoes preoperative evaluation to assess the severity of strabismus and determine the appropriate surgical approach.
  2. Strabismus surgery is performed under general anesthesia or local anesthesia with sedation, depending on the complexity of the case.
  3. Postoperatively, the patient may experience temporary discomfort, redness, and swelling in the eye area.
  4. Follow-up appointments are scheduled to monitor the alignment of the eyes and adjust any necessary postoperative care.
  5. Visual rehabilitation may be recommended to help the patient adjust to the corrected alignment of the eyes.
  6. In some cases, additional surgeries or interventions may be needed to achieve optimal alignment and visual outcomes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery?
  2. How successful is strabismus surgery in correcting misalignment of the eyes?
  3. What type of anesthesia will be used during the surgery?
  4. What is the recovery process like after strabismus surgery?
  5. How long will it take to see improvement in eye alignment after the surgery?
  6. Will additional treatments or follow-up surgeries be needed after the initial strabismus surgery?
  7. Are there any lifestyle or activity restrictions to be aware of after strabismus surgery?
  8. How experienced is the surgeon in performing strabismus surgery?
  9. Are there any alternative treatment options to consider before proceeding with surgery?
  10. What can I expect in terms of post-operative care and monitoring?

Reference

Authors: Johnson WJ, Bitner DP, Bacig C. Journal: J AAPOS. 2024 Dec;28(6):104047. doi: 10.1016/j.jaapos.2024.104047. Epub 2024 Nov 15. PMID: 39550053