Comparison of Two Conjunctival Incision Techniques in Strabismus Operations: Analysis of the Patient Population in 2008, 2010 - 2014.

Abstract

Until 2010, the Halle university hospital used the limbal approach in strabismus operations to open the conjunctiva, as first described by Harms in 1949. In 2010, this was changed the to a modified radial incision technique, as inspired by the fornix incision of Harms and the "minimally invasive strabismus surgery" (MISS) technique of D. S. Mojon. The indication is the reduction in complications and protection of the conjunctiva. A retrospective analysis was performed of cases between 2008 and March 2014 was performed, including a total of 258 patients. 109 patients were treated with the limbal approach and 149 patients with the radial cut. The following aspects were included for comparison: the medium-term control of the squint angle after three months, intra- and postoperative number of complications, duration of the operations. A survey collected the reasons for not taking part in follow-up checks and the alignment of these patients. To compare binary variables, the chi-square-test was used and to compare average terms the unpaired t test, with a level of significance of 0.05%. The results of the postoperative square angles were comparable to both each other as to the literature. The number of complications was kept low in both techniques. The duration of the operations under the radial incision technique was clearly higher. However, throughout the observed years the duration of operations turned out to have decreased. The reasons for not taking part in controls were diverse and the alignment of these patients was high, regardless of the incision technique. The limbal approach was a well-proven method to open the conjunctiva. After changing to the radial incision technique, there was never a negative influence on the results of the surgeries or the rate of complications. The duration of the operations was extended. Superiority of the new technique was not shown. It could however be an alternative, as it spares the conjunctiva and permits glaucoma operations.