Session: Free papers Session IV - Eye muscle surgery

Comparison of resection and plication in horizontal strabismus surgery

Introduction: Plication and resection are common tightening procedures in strabismus surgery. Surgical outcomes of both techniques are debated. The aim of the study was to compare the results of both techniques on a large cohort of patients.

 

Methods: 181 consecutive patients (109 with exotropia, 72 with esotropia) who underwent strabismus surgery (87 with resection, 94 with plication) were retrospectively reviewed. Binocular alignment and success rates were assessed 12 months after surgery. Success was achieved by a deviation angle ≤ 10 prism diopters (PD). Post operative pain level at 1 day was collected using the visual analogue scale (VAS).

 

Results: The mean preoperative deviation angle at distance was 37.9 +/- 14.3 PD (mean +/- standard deviation) for the resection group and 28.4 +/- 10.7 PD for the plication group (p< 0.0001). At the 12-month follow-up visit, deviation angles at distance were reduced to 9.5 +/- 8.4 PD after resection and 8.5 +/- 7.2 PD after plication (p=0.38). Surgical success rate was 71.2% after resection and 58.5% after plication (p=0.073) and considering exotropia only it was 80.8% after resection and 63.4% after plication (p=0.056). Anesthetic time was longer for resection (31.0 +/- 4.7 min) than plication (29.38 +/- 5.05 min), (p=0.02).  Pain was higher after resection (4.82 +/- 2.25) than plication (3.99 +/- 1.81), (p=0.006).

No significant differences were found in ocular motricity, diplopia, reintervention rates and aesthetic satisfaction rates.

Conclusions: Resection achieved better surgical success rates, especially in exotropia, though not in a statistically significant way, while having no other serious pejorative repercussions on patients.