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Year : 2018  |  Volume : 19  |  Issue : 2  |  Page : 153-158

Minimally invasive strabismus surgery versus fornix-based incision technique

Ophthalmology Department, Menoufia University, Shebin El-Kom, Menoufia Governorate, Egypt

Correspondence Address:
Nermeen M Badawi
FRCS Ophthalmology (Glasgow), Compound Lake View, 90th Street, Villa 3/1, New Cairo 11835, Cairo Governorate
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DJO.DJO_56_17

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Purpose The aim of the present study was to compare the minimally invasive strabismus surgery (MISS) and the Parks’ fornix-based incision technique. Patients and methods A total of 60 horizontal muscles of 50 eyes of 30 consecutive patients in need for horizontal rectus muscle surgery were included in the present study. They were divided into two groups: group A included surgeries performed with the MISS technique and group B included those performed using the fornix-based incision technique. The comparison addresses both the surgical techniques and the postoperative results, with a follow-up period of 6 months. Results The operative time was relatively longer in cases of MISS (51.79 min) compared with the fornix incision (30.71 min, P<0.05). The wound size and the number of sutures required to close the wounds were 2–4 sutures (1–2 for each incision) in MISS surgeries, whereas 1–2 sutures were required in the fornix incision technique (P>0.05). Regarding postoperative visibility of the conjunctival signs, signs were hardly visible in 75% of small-sized incisions of MISS cases and in 100% of small-sized incisions in cases of fornix-based incision cases (P<0.05). In medium-sized incisions, both techniques were comparable to each other with moderate signs (P>0.05). Finally, in large-sized incisions, the MISS technique showed better results with less visibility of severe postoperative conjunctival signs (66.7%) than those of fornix-based incision (96%, P<0.05). By the end of the follow-up period, 13 (86.6%) of 15 cases became orthophoric (i.e. angle of deviation less than 10 diopters) in group A, whereas 14 (93.3%) of 15 cases became orthophoric in group B (P>0.05). Conclusion Each of the two techniques has its advantages. A definite superiority cannot be confirmed. However, it may be safer to use the MISS in elderly people with inelastic conjunctival tissue.

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