Single Minimal Conjunctival Incision for Strabismus

Purpose/Background: To study the feasibility and inflammatory response of surgery for rectus muscles using a small single bulbar conjunctival incision posterior and parallel to the muscle insertion.

Methods: Patients requiring surgery of at least one rectus muscle with several diagnoses, operated under general or topical / sub-Tenon's anesthesia, who had no previous eye muscle surgery, are included. Routinary clinical ophthalmological examination is carried out. After applying a 5-0 PGA traction suture, a 3-4 mm single conjunctival incision posterior and parallel to the rectus muscle insertion will be done. A hang-back recession with 6-0 PGA suture will be carried out, and the conjunctiva closed by an 8-0 PGA single stitch. The main outcome measure is duration of swelling and hemorrhage, and secondary outcome measure is motor outcome at 2 months after surgery. Results are compared with retrospectively collected data of patients operated using limbal (n= 20) and fornix incision (n= 21) as a point of reference.

• single minimal conjunctival incision (Procedure): A 5-0 PGA traction suture was used near the corneal limbus corresponding to the operated muscle. A 3-4 mm single conjunctival incision posterior and parallel to the insertion in medial, lateral or superior rectus muscle was used. A hang-back recession of the muscle was done using 6-0 PGA suture. The conjunctiva was closed by an 8-0 PGA single stitch with knot burial

Primary outcomes

• Duration of conjunctival swelling/hemorrhage [2 months]: Evaluate duration of conjunctival swelling/hemorrhage

Secondary outcomes

• Motor outcome at 2 months after surgery (by Prism and Alternate Cover Test) [2 months]: Evaluate motor status at 2 months after surgery

Sex: All, ages: 6 Years to 60 Years

Inclusion Criteria:

* patients requiring surgery of at least one rectus muscle with several diagnoses, operated under general or topical / sub-Tenon's anesthesia

Exclusion Criteria:

* patients had no previous eye muscle surgery

• Jaime Tejedor, MD, PhD, Principal investigator, Universite Abdou Moumouni de Niamey, Niger