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Changes in conjunctival–scleral thickness after strabismus surgery measured with anterior segment optical coherence tomography

  • Hiroko Suzuki
  • Akiko Hikoya
  • Miwa Komori
  • Risako Inagaki
  • Takashi Haseoka
  • Shinji Arai
  • Yuri Takagi
  • Yoshihiro Hotta
  • Miho Sato
Clinical Investigation
  • 36 Downloads

Abstract

Purpose

To evaluate changes in conjunctival–scleral thickness following strabismus surgery with anterior segment optical coherence tomography (AS-OCT).

Study Design

Prospective, observational, consecutive case series.

Methods

Distances between the conjunctival epithelium and inner scleral wall were measured with AS-OCT before and 3–5 months after strabismus surgery. The measurements were performed at 1.5 mm (limbus), 7.0 mm (insertion), and 8.0 mm (tendon) posterior to the scleral spur on the lateral rectus muscle (LR); and 1.5 mm (limbus), 4.0 mm (insertion), and 5.5 mm (tendon) posterior to the scleral spur on the medial rectus muscle (MR). Thirty-three extraocular muscles (20 LRs and 13 MRs) from 23 subjects were studied.

Results

Thicknesses were significantly less at the insertion (0.95–0.78 mm; p < 0.001) and tendon (0.99–0.78 mm; p < 0.001) after LR recession and at the tendon (1.21–0.92 mm; p = 0.02) after MR recession. Thicknesses were significantly greater at the insertion (0.82–1.07 mm; p = 0.01) and tendon (0.95–1.28 mm; p = 0.01) after MR resection or plication and at the limbus, insertion, and tendon (0.75–0.90 mm, 0.94–1.19 mm, 1.03–1.28 mm, respectively; all p = 0.04) after LR resection or plication.

Conclusion

Conjunctival–scleral thicknesses showed various changes after recession and resection or plication. These findings may help detect previous surgical operations when conjunctival scarring and ciliary vessel changes are unclear.

Keywords

Anterior segment optical coherence tomography Conjunctival–scleral thickness Recession Resection Strabismus surgery 

Notes

Acknowledgements

This work was supported by JSPS KAKENHI [grant number JP16K11264]. We would like to thank Editage for English-language editing.

Conflicts of interest

H. Suzuki, None; A. Hikoya, None; M. Komori, None; R. Inagaki, None; T. Haseoka, None; S. Arai, None; Y. Takagi, None; Y. Hotta, None; M. Sato, None.

References

  1. 1.
    Liu X, Wang F, Xiao Y, Ye X, Hou L. Measurement of the limbus-insertion distance in adult strabismus patients with anterior segment optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;52:8370–3.CrossRefPubMedGoogle Scholar
  2. 2.
    Park KA, Lee JY, Oh SY. Reproducibility of horizontal extraocular muscle insertion distance in anterior segment optical coherence tomography and the effect of head position. J AAPOS. 2014;18:15–20.CrossRefPubMedGoogle Scholar
  3. 3.
    Rossetto JD, Cavuoto KM, Allemann N, McKeown CA, Capó H. Accuracy of optical coherence tomography measurements of rectus muscle insertions in adult patients undergoing strabismus surgery. Am J Ophthalmol. 2017;176:236–43.CrossRefPubMedGoogle Scholar
  4. 4.
    Ngo CS, Smith D, Kraft SP. The accuracy of anterior segment optical coherence tomography (AS-OCT) in localizing extraocular rectus muscles insertions. J AAPOS. 2015;19:233–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Häner NU, Dysli M, Abegg M, Zinkernagel MS. Enhanced-depth optical coherence tomography for imaging horizontal rectus muscles in graves’ orbitopathy. Graefes Arch Clin Exp Ophthalmol. 2015;253:1569–73.CrossRefPubMedGoogle Scholar
  6. 6.
    Ludwig IH. Scar remodeling after strabismus surgery. Trans Am Ophthalmol Soc. 1999;97:583–651.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Parks MM. Fornix incision for horizontal rectus muscle surgery. Am J Ophthalmol. 1968;65:907–15.CrossRefPubMedGoogle Scholar
  8. 8.
    Mojon DS. Comparison of a new, minimally invasive strabismus surgery technique with the usual limbal approach for rectus muscle recession and plication. Br J Ophthalmol. 2007;91:76–82.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Mojon DS. Minimally invasive strabismus surgery for horizontal rectus muscle reoperations. Br J Ophthalmol. 2008;92:1648–52.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Mojon DS. Minimally invasive strabismus surgery (MISS) for inferior obliquus recession. Graefes Arch Clin Exp Ophthalmol. 2009;247:261–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Mojon DS. Minimally invasive strabismus surgery for rectus muscle posterior fixation. Ophthalmologica. 2009;223:111–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Salcedo-Villanueva G, Paciuc-Beja M, Harasawa M, Velez-Montoya R, Olson JL, Oliver SC, et al. Identification and biometry of horizontal extraocular muscle tendons using optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2015;253:477–85.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2018

Authors and Affiliations

  • Hiroko Suzuki
    • 1
  • Akiko Hikoya
    • 1
  • Miwa Komori
    • 1
  • Risako Inagaki
    • 1
  • Takashi Haseoka
    • 1
  • Shinji Arai
    • 1
  • Yuri Takagi
    • 1
  • Yoshihiro Hotta
    • 1
  • Miho Sato
    • 1
  1. 1.Department of OphthalmologyHamamatsu University MedicineHamamatsuJapan

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