Ari Leshno1, Daphna Mezad-Koursh2, Tomer Ziv-Baran3, Chaim Stolovitch4. 1. Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv, Israel. Electronic address: arileshno@gmail.com. 2. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel. 3. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel; Assuta Medical Center, Tel Aviv, Israel.
Abstract
PURPOSE: To quantify refractive changes following horizontal lateral rectus recession and medial rectus resection surgery and to investigate the causes of these changes. METHODS: The medical records of patients who underwent unilateral horizontal lateral rectus recession and medial rectus resection for exotropia by a single surgeon over a period of 14 years were reviewed retrospectively. Using vector analysis, refractive changes in operated eyes (cases) were compared to changes in the sound eyes (controls). The main outcome measures were differences in mean change of refractive parameters and the proportion of clinically significant changes. RESULTS: A total of 31 subjects (median age, 13.6 years; interquartile range, 8.8-19.8 years) were included. A significantly higher magnitude of refractive changes was observed in the operated eyes (P = 0.001). In addition, the proportion of cases with clinically significant change in sphere or cylinder was significantly higher in the operated eyes compared to the sound eyes (48% vs 10% [OR = 2.31, P = 0.002] and 32% vs 10% [OR = 5.0, P = 0.039], resp.). CONCLUSIONS: Horizontal strabismus surgery is associated with refractive changes that might be of clinical significance. Pediatric ophthalmologists should consider re-refraction 1 month postoperatively.
PURPOSE: To quantify refractive changes following horizontal lateral rectus recession and medial rectus resection surgery and to investigate the causes of these changes. METHODS: The medical records of patients who underwent unilateral horizontal lateral rectus recession and medial rectus resection for exotropia by a single surgeon over a period of 14 years were reviewed retrospectively. Using vector analysis, refractive changes in operated eyes (cases) were compared to changes in the sound eyes (controls). The main outcome measures were differences in mean change of refractive parameters and the proportion of clinically significant changes. RESULTS: A total of 31 subjects (median age, 13.6 years; interquartile range, 8.8-19.8 years) were included. A significantly higher magnitude of refractive changes was observed in the operated eyes (P = 0.001). In addition, the proportion of cases with clinically significant change in sphere or cylinder was significantly higher in the operated eyes compared to the sound eyes (48% vs 10% [OR = 2.31, P = 0.002] and 32% vs 10% [OR = 5.0, P = 0.039], resp.). CONCLUSIONS: Horizontal strabismus surgery is associated with refractive changes that might be of clinical significance. Pediatric ophthalmologists should consider re-refraction 1 month postoperatively.