Horizontal Şaşılıklarda Ekstraoküler Kas Yerleşiminin ve Gözün Aksiyel Uzunluğunun Cerrahi Başarıya Etkisi

Abstract

The purpose of this study is to evaluate the biometric properties of the eye and the effect of extraocular muscle configuration on the success of horizontal strabismus surgery. Eighty-seven patients who underwent surgical treatment for horizontal strabismus were included in our study. Ophthalmologic, orthoptic and biometric examination findings were recorded preoperatively and postoperatively in the third month of patients who underwent strabismus surgery. In addition to routine examination, axial length and keratometry parameters were evaluated. During the operation, limbus - medial and lateral muscle insertion were recorded as upper (a), middle (b) and lower (c) distances. The muscle insertion width (d) was recorded. Muscle alignment was recorded as either oblique or flat according to its orientation throughout the orbit till its insertion. At the time of surgery, the mean age of the patients was 7.79±7.43 (1.0-38.0). The patients were divided into three groups as esotropia, exotropia and infantile esotropia. The patients were divided into the success group (postoperative deviation ≤10 pd ET for esotropia; ≤10 pd ET to ≤10 pd XT for exotropia); partial success (one of the near- or far-deviation was <10 pd ET for esotropia and <10 XT for exotropia); and the failure group (postoperative deviation was >10 pd ET for esotropia and >10 pd XT for exotropia). Surgery was successful in 41 (47.1%) patients, 33 (37.9%) were partially successful and 13 (4%) were unsuccessful. There was no relationship between refractive error, deviation type, fusion and stereopsis presence and surgical success (p=0,403; p=0,183; p=0,316; p=0,259). The distance from the limbus, ('d') width of the internal rectus insertion ('a', 'b', 'c') was found to be positively correlated with surgical success rate (p=0,058; p=0,026; p=0,019; p=0,058). On the other hand, axial length and amount of near-deviation were negatively correlated with surgical success rate (p=0,031; p=0,021). In conclusion, it has been shown that axial length and extraocular muscle anatomy are among the factors affecting surgical success in horizontal strabismus