Purpose: To discuss the importance of axial length (AxL) in strabismus surgery and the utility of its association to preoperative deviation data, in calculating the amount of recession to perform in patients affected by convergent strabismus. Methods: Case files of 28 patients, affected by non accommodative esotropia, who underwent recession of one or both medial rectus, in our department between 2009 and 2011, were analyzed. Subject 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) were all evaluated. Post operation angle of deviation was evaluated after 3 months from intervention. Results: 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, between pre- and post-operation. Percent reduction in shorter AxL was 66.37% (ND)and 68.22% (FD); reduction in longer AxL was 81.78 % (ND) and 87.09% (FD) Conclusion: 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, preoperative deviation appears to be the most important parameter that must be take into account before strabismus surgery. Importance, besides, has been given to globe size considering both axial length and external surface, but in many reports, conclusions do not agree with our clinical experience.
The role of axial length (AxL) in planning strabismus surgery
GALANTUOMO, MARIA SILVANA;FOSSARELLO, MAURIZIO;ZUCCA, IGNAZIO ALBERTO
2013-01-01
Abstract
Purpose: To discuss the importance of axial length (AxL) in strabismus surgery and the utility of its association to preoperative deviation data, in calculating the amount of recession to perform in patients affected by convergent strabismus. Methods: Case files of 28 patients, affected by non accommodative esotropia, who underwent recession of one or both medial rectus, in our department between 2009 and 2011, were analyzed. Subject 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) were all evaluated. Post operation angle of deviation was evaluated after 3 months from intervention. Results: 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, between pre- and post-operation. Percent reduction in shorter AxL was 66.37% (ND)and 68.22% (FD); reduction in longer AxL was 81.78 % (ND) and 87.09% (FD) Conclusion: 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, preoperative deviation appears to be the most important parameter that must be take into account before strabismus surgery. Importance, besides, has been given to globe size considering both axial length and external surface, but in many reports, conclusions do not agree with our clinical experience.
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