Squint Free Papers - aioseducation

824
70th AIOC Proceedings, Cochin 2012
25 patients were operated by bilateral MR recession (BMRc), 3 patient under
went BMRc + LR resection and one patient under went unilateral recessionresection.
Out of 15 patients with exotropia bilateral LR recession (BLRc) was
done in 7 patients, unilateral recession-resection in 5 patients and BLRc + MR
resection was done in 3 patients. Average preoperative angle of deviation
was (A) 43.64±13.61 PD (ET 46.21±14.67 PD and XT 38.67±9.9 PD). Amount of
surgery performed on horizontal muscles in each patient was correlated with
standard table used by individual surgeon for their routine squint surgeries
(in normal children). This comparison with the standard table gave us angle
of deviation (B) which would have been corrected in a normal child with the
same amount of surgery.
No complications were observed during or after the surgery. Ocular
examination including angle of deviation, ocular movements and cycloplegic
refraction, were performed at 6 week in all patients. Successful outcome was
defined as within 10 PD of orthophoria.
RESULTS
Out of total 44 (30 male, 14 female) children, esotropia was found in 29 (65.90%)
(21 male, 8 female) and exotropia was present in 15 (34.09%)children (9 male, 6
female). Mean spherical equivalent pre-operatively was +1.05 ± 2.30 in patients
with esotropia and +0.42 ±1.35 in patients with exotropia. Nystagmus was
present in 9 (5 esotropic and 4 exotropic) children.
Average preoperative angle of deviation was (A) 43.64±13.61 PD (ET 46.21±14.67
PD and XT 38.67±9.9 PD). Amount of surgery performed on horizontal muscles
in each patient was correlated with standard table used for normal children
to get the angle of deviation (B) which would have been corrected in a normal
child with the same amount of surgery. This operated angle of deviation
(B) was expressed as percentage of pre operative angle of deviation (A). On
an average 75.67%±14.71 (ET-73.9% ±15.62 and XT–79.08%±12.53) of angle of
deviation was operated. For example one patient having 25 PD esotropia was
operated for both eyes MR recession 3.5 mm by surgeon 1. When compared
with the standard surgical table used by surgeon 1, this amount of surgery is
supposed to correct 20 PD of esotropia. So amount of surgery performed was
80% (20PD) of the pre-operative angle (25PD).
Surgical success was determined at 6 week post operative follow up. Longer
follow-up was not selected because long term stability of angle is affected
by many factors other than surgical factors. Out of 44 patients successful
outcome was noted in 27 (61.36%) patients at 6 weeks post operative.
Among patients with esotropia successful outcome was noted in 17 out of
29 (58.62%) and among patients with exotropia 10 out of 15 (66.66%) patients
had successful outcome. Among patients with successful outcome average