What's new AAPOS 2008 - The Private Eye Clinic

STRABISMUS SURGERY
Unilateral recession-resection in children with exotropia of the convergence
insufficiency type.
Choi MY, Hyung SM, Hwang JM.
Eye. 2007 Mar;21(3):344-7.
The purpose of this study was to evaluate prospectively the long-term surgical results of
unilateral lateral rectus muscle recession and medial rectus muscle resection in
children with intermittent exotropia of the convergence insufficiency type. A total of 14
children with intermittent exotropia greater at near than at distance by 10 prism diopters
(PD) or more were included in this prospective study. The amounts of resection and
recession were based on near and distance deviation, respectively. Minimum follow-up
was 1 year (mean 26.6 months; range, 12-68 months) after surgery. Significant
postoperative reduction was achieved in terms of mean distance exodeviation, from
22.5 PD to 9.1 PD (P=0.000), and mean near exodeviation from 33.8 PD to 13.6 PD
(P=0.000). Mean near-distance difference reduced from 11.3 PD preoperatively to 4.6
PD postoperatively (P=0.000). Fresnel prism was used temporarily to treat
postoperative esotropia in only one patient for postoperative 6 months. Unilateral
surgery biased to MR strengthening more than LR weakening in children with
intermittent exotropia of the convergence insufficiency type, was found to successfully
reduce both distance and near deviation and to collapse near-distance differences with
a low risk of long-term postoperative esotropia.
Effect of prophylactic brimonidine instillation on bleeding during strabismus
surgery in adults.
Hong S, Kim CY, Seong GJ, Han SH.
Am J Ophthalmol. 2007 Sep;144(3):469-70.
PURPOSE: To investigate the effects of preoperative brimonidine-purite 0.15%
instillation on intraoperative bleeding and postoperative subconjunctival hemorrhage
during strabismus surgery in adult patients.
METHODS: One hundred and eighteen eyes of 90 consecutive adult patients were
instilled with either a single drop of brimonidine-purite 0.15% (42 eyes), phenylephrine
1% (38 eyes), or sodium hyaluronate 0.1% (38 eyes) 15 minutes prior to strabismus
surgery. Intraoperative bleeding and postoperative subconjunctival hemorrhage were
graded on a scale of one to three. The scores were compared among the study groups.
RESULTS: Scores of the intraoperative bleeding and the postoperative subconjunctival
hemorrhage of the treatment groups were significantly less than that of the control
group (P < .001). The scores of the brimonidine group were similar to those of the
phenylephrine group (intraoperative bleeding score, P = .405; subconjunctival
hemorrhage score, P = .722).
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