Refractive Changes Induced by Recession of the Medial Rectus and the Inferior Oblique Muscles

Abstract

Purpose: To investigate refractive changes after strabismus correction by combined recession of the Medial Rectus (MR) and Inferior Oblique (IO) muscles. Methods: We reviewed cases of combined MR and IO recession. Individuals with both preoperative refraction measurement and one month postoperative measurements were included. Double-angle mathematical methods for subtraction of refraction were used in order to calculate the surgical induced refractive change. Paired-sample Wilcoxon signed rank test and one-sample binomial tests were used to identify significant postoperative refractive changes. The prevalence of clinically significant changes was also evaluated. Results: Fifty-five eyes from 28 subjects met the criteria and were included in the final analysis. A substantial rate (>50%) of clinically significant refractive changes resulting in a myopic shift and a positive increase in cylinder power towards with-the-rule direction were observed after combined recession of MR and IO. The rate of significant changes in terms of SE was lower. There was no correlation between the recession extent and amount of refractive change and no significant differences were observed between types of IO weakening procedure. Conclusion: Refractive changes are a significant side effect of combined recession of MR and IO, and patients should be informed regarding the possibility of such complication prior to the procedure and close postoperative observation is warranted to prevent amblyopia. Citation: Daphna M-Z, Tomer Z-B, Ofira Z, Sharon BM, Chaim S, et al. (2019) Refractive Changes Induced by Recession of the Medial Rectus and the Inferior Oblique Muscles. J Ophthalmic Clin Res 6: 053.