RETINAL PERFORATION IN STRABISMUS SURGERY

Purpose: Perforation of the retina is a major complication of strabism us surgery. The reported incidence of perforation varies from 0.13% to 12%. This study was undertaken to determine, from a large collaborati ve database, the incidence of suspected and unsuspected retinal and ch oroidal injury in pediatric horizontal muscle surgery. Method: All chi ldren with horizontal strabismus surgery seen between September 1992 a nd October 1995 were examined with indirect ophthalmoscopy immediately following their procedure. Surgery was performed by both resident and attending physicians. Cases involving muscle reoperation, high myopia , or patients with connective tissue disorders were excluded. Results: Strabismus surgery was performed on 765 patients, who underwent 1129 muscle recessions and 349 muscle resections. These children also had 1 61 vertical or oblique muscle procedures performed. Intraocular trauma resulting from horizontal muscle surgery was noted in 14 patients, in cluding three retinal perforations. One of these patients was treated with cryotherapy; the other two received no therapy other than intraop erative and postoperative antibiotics.