The Evaluation of Anterior Segment Circulation after Strabismus Surgery by using Indocyanine Green(ICG) Iris Angiography

Kwon, Soon Il; Shin, Min Chul; Choi, Dong Gyu

Abstract

Anterior segment ischemia is a rare, but serious complication of strabismus surgery, Iris microvascular circulation in eyes with blue irides has been investigated by fluorescein iris angiorgaphy, which failed to demonstrate the iris vascular pattern in eyes with heavily pigmented irides like Oriental brown iris. Anterior segment circulation in eyes of Korean after strabismus surgery was investigated by iris angiography using indocyanine green(ICG), which highly penetrates through the pigmented tissue or hemorrhage ICG iris angiography using confocal scanning laser ophthalmolscope was performed before and after strabismus surgery in 20 eyes of 20 Koreans. Tenotomies of medial and lateral recti produced no appreciable circulatory disturbance in the iris in any patients, but there was mild delayed filling in 2 eyes of 6 eyes undergoing tenotomy of one or both vertical recti. When tenotomies of a horizontal and a vertical rectus were combined, the filling defect occurred in the region of radial vessels was observed in eyes with tenotomies of medial rectus and lateral halves of superior and inferior recti. Our study suggests that ICG iris angiography is a useful means for the evaluation of anterior segment circulation I darkly pigmented iris like Oriental brown iris. And there was the remarkable change in iris microvascular circulation only after tenotomy of multiple muscles including vertical rectus muscles.