الفهرس | Only 14 pages are availabe for public view |
Abstract Surgical management of strabismus remains a challenge because surgical success rates, short-term and long-term are not usually ideal so reoperation may be required. There are many risk factors that may increase the incidence of postoperative unsatisfactory alignment after strabismus surgery either, improper diagnosis, improper surgical decision making or improper surgical procedure. These factors can be avoided as possible, but there will remain unavoidable factors related to the nature of strabismus which is not just a mechanical problem,but due to complex neuromuscular and sensory systems. That’s why the exact effect of strabismus surgery for each individual patient is difficult to predict. For any type of strabismus procedure that is performed, there will be a risk for some patients to be overcorrected, and also some other patients may beundercorrected. Reoperation of strabismus is a challenge as there is more difficulty in establishing the surgical decision and there is difficulty in the surgical procedure itself due to altered anatomy and unexpected surgical surprises. This prospective study included 30 patients attending the outpatient clinic of Mansoura Ophthalmic Center during the period from November 2013 to November 2014. The aim was to find out the types and causes of strabismus reoperation in Mansoura ophthalmic center and to study the risk factors for reoperation, either patient related or operation related. After history taking, preoperative detailed ophthalmologic examination was performed including visual acuity measurement, slit lamp biomicroscopy, tonometry, fundus examination, ocular motility examination and measurement of the angle of deviation. Reoperation was done for all cases. All cases were followed up for 6 months postoperatively. Four visits were arranged for every case postoperatively at 1 week, 1month, 3 months and 6 months. In each visit, complete ophthalmic examination were done for every case. There was 16 patients presented with residual deviations, 5 patients with consecutive deviation, one patient with new vertical deviation and 8 patients with mixed new with either residual or consecutive deviation. Postoperative results, early and 6 months follow up, showed that 18 patients became orthotropic after reoperation, 5 patients became orthotropic on glasses after reoperation and 7 patients needed re-reoperation. |