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Abstract
Purpose
The clinical features of esotropia after bare scleral pterygium surgery and dipolpia treatment results were eval-uated in the present study.
Methods
Twenty eyes of 12 patients who had esotropia after bare sclera pterygium surgery from 2008 to 2011 were retro-spectively investigated.
Results
Diplopia occurred at 2.8 ± 1.6 months (1-6 months) after pterygium surgery. The mean pre-operative angle of eso-tropia was 19.4 ± 8.9 PD (8-40 PD) at distance and 16 ± 7.3 PD (0-30 PD) at near. All patients showed limitation of abduc-tion in the pterygium operated eye. Two patients were prescribed prism glasses, 2 patients underwent conjunctiva surgery, and medial rectus recession with simultaneous intraoperative adjustment surgery was performed in 8 patients. An addi-tional strabismus operation was required for 2 patients who received conjunctival surgery due to diplopia recurrence. Seven patients (70%) showed orthotropia at 3 months.
References
1. Kim JH, Lee JE, Lee JS. Superior-inferior sliding conjunctival flap for pterygium with a Fibrin tissue adhesive (Tisseel(R)). J Korean Ophthalmol Soc. 2006; 47:2041–6.
2. Cho Y. The treatment of esodeviation with abduction deficiency caused by recurrent pterygium. J Korean Ophthalmol Soc. 1991; 32:1110–5.
3. Ela-Dalman N, Velez FG, Rosenbaum AL. Incomitant esotropia following pterygium excision surgery. Arch Ophthalmol. 2007; 125:369–73.
4. Xia Q, Huang Z, Shen DA, Dai H. Clinical analysis of the diplopia and strabismus after ophthalmic surgeries. Zhonghua Yan Ke Za Zhi. 2003; 39:727–30.
5. Jenkins PF, Stavis MI, Jenkins DE 3rd. Esotropia following ptery-gium surgery. Binocul Vis Strabismus Q. 2002; 17:227–8.
6. Raab EL, Metz HS, Ellis FD. Medial rectus injury after pterygium excision. Arch Ophthalmol. 1989; 107:1428.
7. Ugrin MC, Molinari A. Disinsertion of the medial rectus following pterygium surgery: signs and management. Strabismus. 1999; 7:147–52.
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Figure 1.
(A) Note clear bare sclera bed and non-significant conjunctival cicatrical changes in ocular surface (white arrow). (B) Extensive fibro-vascular scar formation in pterygium excision surgery area (Black arrow).
Figure 2.
(A) Preoperative photograph of patient number 6. (B) The postoperative photograph shows orthotropia after bilateral me-dial rectus muscle recession with left medial rectus muscle intraoperative adjustment.
Figure 3.
(A) Preoperative photograph of patient. The patient shows orthotropia at 1 month after conjunctiva scar revision with amniotic membrane graft surgery. (B) 3 months after conjunctiva surgery combined with amniotic membrane graft, diplopia recurred. (C) Postoperative photograph of patient. The patient shows orthotropia after medial rectus recession surgery.
Table 1.
Summary of clinical data of patients
| No | Age/Sex | Op Side | Op method | Onset of Diplopia | Pre Op Alignment | 1 st Tx | 2nd Tx | Final Alignment |
|---|---|---|---|---|---|---|---|---|
| 1 | F/55 | OD | B | 1M | RET 20 PD | OD C* + AG‡ | S† | Ortho |
| 2 | F/53 | OD | B, OD Re op | 1M | RET 12 PD | P | ET 12 PD | |
| 3 | M/39 | OS | B, OS Re op | 2M | LET 25 PD | OS S† + AM | Ortho | |
| 4 | F/51 | OU | B, OD Re op | 3M | RET 14 PD | OD S† + AG‡ | Ortho | |
| 5 | M/52 | OU | B, OU Re op | 3M | ET 30 PD | OU S† + AM | Ortho | |
| 6 | M/53 | OU | B, OU Re op | 2M | LET 40 PD | OU S† | P | ET 8 PD |
| 7 | M/56 | OU | B | 6M | RET 12 PD | OD C* + AM | OD S† | ET 6 PD |
| 8 | M/59 | OU | B | 3M | RET 16 PD | OD S† | Ortho | |
| 9 | M/59 | OU | B | 4M | LET 20 PD | OS S† | ET 6 PD | |
| 10 | M/51 | OU | B | 1M | LET 16 PD | OS S† | Ortho | |
| 11 | M/58 | OU | B | 3M | ET 8 PD | P | ET 8 PD | |
| 12 | M/42 | OS | B, OS Re op | 5M | LET 20 PD | OS S† + AG‡ | Ortho |
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