Abstract
This study examined the factors affecting corneal curvature change after lateral rectus recession and medial rectus resection surgery in patients with intermittent exotropia. This was a retrospective cross-sectional study in intermittent exotropia patients who underwent rectus resection surgery. The study involved 41 male and 42 female patients (mean age: 9.55 ± 5.03 years, range: 3-28 years). Corneal astigmatism analysis was performed using the Galilei G4 Dual Scheimpflug Analyzer. The values of simulated and ray tracing corneal keratometry (K) of astigmatism, including axis changes, were determined preoperatively and at 1 week and 3 months postoperatively. The factors found to affect corneal curvature change were sex, extent of surgery, and axial length. Simulated and ray tracing changes were significant preoperatively and at 1 week and 3 months after rectus resection surgery (p < 0.05); however, there were no differences in astigmatism (D) at any time. The spherical equivalent had a myopic change after rectus resection surgery with cycloplegic refraction, and in ray tracing mode, flat K was decreased at 1 week from baseline and increased 3 months later. Steep, mean K, and axis increased continuously from baseline to 1 week and 3 months. Astigmatism, in contrast, was increased at 1 week, but decreased at 3 months, with no return to baseline. Univariable linear regression analyses showed that the extent of surgery had an effect on flat K change and that sex had an effect on steep K and axis. Additionally, axial length affected steep K and astigmatism, while age had no effect on any variable. Ray tracing values were significantly different from simulated values. In ray tracing mode, rectus resection surgery may result in astigmatism shifted toward with-the-rule, and myopic changes may be caused by differences in thickness and flexibility of the sclera. Notably, age did not affect any variable.
Highlights
Strabismus is a well-known ocular disorder with a prevalence of 3.8–5% [1]
We retrospectively reviewed the medical records of patients who had undergone lateral rectus recession and resection surgery (R&R) for intermittent exotropia from June 2015 to February 2016
Steep and mean K, astigmatism, and axis were analyzed in ray tracing and simulated mode at the initial visit, 1 week after operation, and 3 months after operation
Summary
Strabismus is a well-known ocular disorder with a prevalence of 3.8–5% [1]. Surgery is a major treatment of choice for strabismus. Surgical correction to reposition the ocular muscle by weakening the lateral rectus muscle and strengthening the medial rectus muscle, . Astigmatism after surgery in patients with exotropia. No funding was received for the conduction of this study
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