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Drift of Ocular Alignment Following Strabismus Surgery Part 1: Using Fixed Scleral Sutures
  1. Parnchat Pukrushpan,
  2. Sherwin J. Isenberg (isenberg{at}
  1. King Chulalongkorn Memorial Hospital, Chulalongkorn University and Jules Stein Eye Institute, Thailand
  2. Jules Stein Eye Institute, United States


    Aims: To evaluate the postoperative alignment drift following traditional strabismus surgery utilizing direct attachment of muscle to sclera.

    Methods: The ocular alignment drift (change from the first postoperative week) of 106 patients who underwent scleral fixation strabismus surgery at age 0.5 to 35 years with 5 years maximal follow-up was analyzed.

    Results: There was a mean undercorrection drift of 4.6 + 8.9 PD at distance fixation (p=0.025) and 3.4 + 7.6 PD at near (p=0.053) for all subjects, and 11.3 + 8.6 PD distance (p=0.008) and 10.6 + 6.0 PD near (p=0.016) for exotropic patients. Recession surgery produced an undercorrection drift of 5.3 + 8.8 PD (p=0.021) at distance fixation. Esotropic patients and those undergoing unilateral recession/resection surgery had no significant drift. Patients overcorrected at the one week postoperative visit later developed an undercorrection drift at distance (10.3 + 7.9 PD, p=0.002) and near fixation (5.5 + 9.2 PD at 36 months, p=0.041), while undercorrected patients showed no significant drift and largely stayed undercorrected.

    Conclusion: Fixed scleral-suture strabismus surgery generally produces a postoperative undercorrection drift, especially following recession surgery, exotropia or overcorrection at the first postoperative week.

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