Healing process and complications after eye muscle surgery

Background:Varying reports on the incidence of operative and postoperative complications following eye muscle surgery have been published. The purpose of this study was to quantify complications after various types of eye mus cle surgery as well as minor pathological changes of the anterior and poste rior segment. Patients and methods: This prospective study included all patients who unde rwent eye muscle surgery at the Department of Strabismology and Neuroophtha lmology, Giessen, from January to May 1998. Five hundred eyes of 377 patien ts aged 2-82 years were included. The spectrum of procedures comprised: rec essions, resections, tucks, R&R procedures, transpositions, bimedial retroe quatorial myopexies, and revisions of rectus and oblique muscles. All patie nts were examined 1 day preoperatively and 1 day, 1 week, and 3 months post operatively. Any complications and even minor pathological changes of the a nterior and posterior segment were documented. Some changes were assessed b y means of a score (0-3). Results: One day postoperatively, 30% of eyes had inflammatory pseudoptosis , most of them mild. Conjunctival swelling and injection were frequently mi ld and moderate,after 1 week mostly mild. Conjunctival irritation was more pronounced following resection than tucking. Punctate epithelial keratopath y was noted in 1.6% of cases (first postoperative day), dellen in 4.3% (fir st postoperative week). Three months postoperatively, 14.3% of eyes had bio microscopically visible conjunctival folds and 91.3% had minimal conjunctiv al scars. None of the patients had a scleral perforation or other serious c omplication. Conclusions: Eye muscle surgery rarely entails complications. Revisions due to organic pathological changes are extremely rare. Possible development o f dellen requires checkup 4-7 days postoperatively. Tucking of rectus muscl es causes less conjunctival irritation than resection.