Purchase this article with an account.
Maria Silvana Galantuomo, Maurizio Fossarello, Alberto Cuccu, Ignazio Zucca; The role of eye axial length in planning strabismus surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4707.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To discuss the importance of axial length (AxL) in strabismus surgery and the utility of its integration to preoperative deviation data, in calculating the amount of recession to perform in patients affected by convergent strabismus.
We analysed case files of 28 patients affected by non accommodative esotropia, who underwent recession of one or both medial rectus in our Clinic between 2009 and 2011. In particular, patients' age, data regarding pre and post-intervention angle of deviation for near (ND) and far distance (FD), and axial length (IOL Master, Carl Zeiss, Jena, Germany) , and post operation angle of deviation after 3 months from intervention were evaluated.
The patients have been divided in two groups in relation to mean AxL (21.78 mm): the former group had less than 21.78 mm, the second a longer AxL. Results have been evaluated as percent reduction of deviation (PRD), between pre- and post-intervention. PRD in shorter AxL was 66.37% (ND) and 68.22% (FD); reduction in longer AxL was 81.78 % (ND) and 87.09% (FD)
Our results show that the recession of an extraocular muscle is more effective in a larger eye than in a small one. Axial length seems to be an import factor in predicting results of strabismus surgery and should be routinely obtained before any operation, in order to increase the amount of recession in shorter eyes. A large number of dose-response curves have been proposed over time, as well the mechanisms that underlie a satisfactory outcome. According to different investigators, the preoperative angle of deviation appears to be the most important parameter that must be take into account before strabismus surgery. Some importance has also been given to globe size, considering both axial length and external surface, but in many reports conclusions do not agree with our clinical experience.
This PDF is available to Subscribers Only