Effect of Axial Length (Myopia) on Horizontal Recti Recession in Children with Horizontal Strabismus

Won-Seok Lee; Jong-Bok Lee; Seung-Han Han

doi:10.3341/JKOS.2011.52.4.472

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Lee, Lee, and Han: Effect of Axial Length (Myopia) on Horizontal Recti Recession in Children with Horizontal Strabismus

Original Article

J Korean Ophthalmol Soc 2011;52(4):472-476.

Published online: 6 September 2011

DOI: https://doi.org/10.3341/JKOS.2011.52.4.472

Effect of Axial Length (Myopia) on Horizontal Recti Recession in Children with Horizontal Strabismus

Won-Seok Lee, M.D., Jong-Bok Lee, M.D., Seung-Han Han, M.D.

The Institute of Vision Research, Department of Ophthalmololgy, Yonsei University of Medicine, Seoul, Korea

Address reprint requests to Seung-Han Han, MD Department of Ophthalmology, Yonsei University Gangnam Severance Hospital #146-92 Dogok-dong, Kangnam-gu, Seoul 135-702, Korea Tel: 82-2-2019-3442, Fax: 82-2-3463-1049, E-mail: shhan222@yuhs.ac

Received 6 August 20101 December 2010 Accepted 27 January 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To assess the influence of axial length for surgical outcome of horizontal recti recession in children with horizontal strabismus.

Methods

A retrospective, non-comparative case series. 100 patients, 96 males and 44 females with unilateral or bilateral high myopia and strabismus surgery was performed. All patients had horizontal recti recession and no combined vertical strabismus. There was no history of any ocular trauma or surgery and no history of any other systemic diseases that affect ocular motility. After horizontal recti recession, the patients were followed-up for more than one year. Data was analyzed using SPSS Software for Windows, version 12.0.1.

Results

In 100 children, the mean axial length was 23.21 ± 1.38 mm (range, 19.63-26.50 mm) and the mean age was 7.43± 2.86 years (range, 1-14 years). Lateral rectus recession was in 89 cases, and medial rectus recession was done in 11 cases. After operation, 86 cases were fully corrected, 11 cases were under corrected and 3 cases were over corrected. Binary logistic regression analysis was performed revealing that, preoperative angle of deviation (p-value 0.062) and axial length (p-value 0.05) were highly correlated with surgical outcome.

Conclusions

Age, preoperative angle of deviation, and axial length may influence the surgical outcome of horizontal recti recession in children. In eyes with long axial length, the surgical outcome of horizontal recti recession appears to be poorer than that in eyes with short axial lengths. Adjusting the recession amounts when performing horizontal recti recessions in long axial length eyes may provide better results.

Keywords: Axial length, Horizontal strabismus, Recti recession

References

1. Lee SJ, Kim JM, Yu BC, et al. Prevalence of myopia in 19-year-old men in Gyeongsangnam-do, Ulsan and Busan in 2002. J Korean Ophthalmol Soc. 2009; 50:1392–403.

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3. Current concepts in strabismus, Korean association for pediatric ophthalmology and strabismus. 2nd ed.Seoul: Naeoui haksul;2008. chap 11-2.

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Table 1.

Demographics

	Full-correction (n = 86)	Under-correction (n = 11)	p-value
Age (mean ± SD, yr)	7.24　± 2.76	9.27　± 3.29	0.062^*
Gender (M:F)	89:4	7:0	1.000^†
Diagnosis (XT:ET)	83:10	6:1	0.570^†
Preoperative AOD^‡ (mean ± SD, PD)	25.76　± 9.59	30.45　± 7.23	0.038^*
Postop AOD^‡ (mean ± SD, PD)	0.45　± 1.69	8.91　± 10.36	<0.001^*
Recession amount (mean ± SD, mm)	6.87　± 1.18	7.09　± 0.86	0.289^*
SE refractive error (mean ± SD, D)	-0.46　± 1.92	-1.19　± 2.79	0.851^*
Axial length (mean ± SD, mm)	23.12　± 1.38	23.88　± 1.39	0.115^*

^* Mann-Whitney U-test;

^† Chi-square test;

^‡ AOD = angle of deviation.

Table 2.

Binary logistic regression analysis I

Independent variables	B	S.E	p-value
Age	0.272	0.111	0.014
Preoperative AOD	0.072	0.036	0.046
Constant	-6.302	1.678	<0.001

B=standardized coefficient, Beta; S.E=standardized coefficient standardized error.

Table 3.

Binary logistic regression analysis II

Independent variables	B	S.E	p-value
Axial length	0.488	0.249	0.050
Preoperative AOD	0.063	0.034	0.062
Constant	-15.261	6.226	6.009

B=standardized coefficient, Beta; S.E=standardized coefficient, standardized error.

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