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

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

• Lee WS
• Lee JB
• Han SH

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.

Keyword

Axial length; Horizontal strabismus; Recti recession

MeSH Terms

Child
Eye
Female
Humans
Logistic Models
Male
Myopia
Retrospective Studies
Strabismus

Reference

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.

2. Kenneth WW, Peter HS. Pediatric ophthalmology and strabismus. 2nd ed.New York: Springer;2003. chap 23.

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

4. Rah SH, Jun HS, Kim SH. An epidemiologic survey of strabismus among school-children in Korea. J Korean Ophthalmol Soc. 1997; 38:2195–9.

5. Park HY, Park SW, Park YG. The study of axial length and func-tional equator in strabismus surgery. J Korean Ophthalmol Soc. 2005; 46:827–36.

6. Kushner BJ, Fisher MR, Lucchese NJ, Morton GV. Factors influencing response to strabismus surgery. Arch Ophthalmol. 1993; 111:75–9.

7. Kushner BJ. Pediatric ophthalmology in the new millennium. Arch Ophthalmol. 2000; 118:1277–80.

8. Kushner BJ, Lucchese NJ, Morton GV. Variation in axial length and anatomical landmarks in strabismic patients. Ophthalmology. 1991; 98:400–6.

9. Kushner BJ, Lucchese NJ, Morton GV. The influence of axial length on the response to strabismus surgery. Arch Ophthalmol. 1989; 107:1616–8.

10. Krzizok TH, Kaufmann H, Traupe H. New approach in strabismus surgery in high myopia. Br J Ophthalmol. 1997; 81:625–30.

11. Yamaguchi M, Yokoyama T, Shiraki K. Surgical procedure for cor-recting globe dislocation in highly myopic strabismus. Am J Ophthalmol. 2010; 149:341–6.