J Korean Ophthalmol Soc.  2013 May;54(5):771-776. 10.3341/jkos.2013.54.5.771.

Clinical Characteristics and Treatment of Esotropia Following Bare Sclera Pterygium Surgery

• Jo SH
• Lee JE
• Choi HY
• Jung JH

• KMID: 2217044
• DOI: http://doi.org/10.3341/jkos.2013.54.5.771

Abstract

PURPOSE
The clinical features of esotropia after bare scleral pterygium surgery and dipolpia treatment results were evaluated in the present study.
METHODS
Twenty eyes of 12 patients who had esotropia after bare sclera pterygium surgery from 2008 to 2011 were retrospectively investigated.
RESULTS
Diplopia occurred at 2.8 +/- 1.6 months (1-6 months) after pterygium surgery. The mean pre-operative angle of esotropia 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 abduction 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 additional strabismus operation was required for 2 patients who received conjunctival surgery due to diplopia recurrence. Seven patients (70%) showed orthotropia at 3 months.
CONCLUSIONS
In this study, diplopia following postoperative adhesion caused by bare sclera pterygium surgery technique was observed. Conjunctiva-perimuscular scar tissue removal and medial rectus recession were effective methods in eliminating diplopia.

Keyword

Adhesion; Esotropia; Pterygium surgery; Recession

MeSH Terms

Cicatrix
Conjunctiva
Diplopia
Esotropia
Eye
Eyeglasses
Glass
Humans
Pterygium
Recurrence
Retrospective Studies
Sclera
Strabismus

Figure

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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).

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  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.

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  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.

Reference

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