Report of results of surgery on virgin extraocular muscles and manipulated extraocular muscles in treatment of consecutive ET, consecutive XT, residual ET and residual XT

The Purpose of study was to report mid-term success of surgery on virgin extraocular muscles (EOMs) or manipulated EOMs (which have been operated in previous surgery) in the management of residual and consecutive esotropia (ET) and exotropia (XT). Of those who had a history of Bilateral medial rectus muscles (BMR) recession or resection, Bilateral lateral rectus muscles (BLR) recession or resection or "Recession and resection" of horizontal rectus muscles (R&R), more than 6 months ago, and had more than 15 prism diopters (PD) of residual or consecutive deviation, 24 patients who meet inclusion criteria not exclusion ones randomized in "Manipulated "or" Virgin" group. Baseline examination including Visual acuity (VA) using Logarithm of minimum angle of resolution (log MAR) and Best corrected visual acuity (BCVA) (log MAR), Refraction (RFN) and baseline Cyclo-refraction (cyclo-RFN) deviation (Cover-Uncover with Krimsky and Hirschberg test using a prism bar) done for all participants. A total of 24 patients distributed in 2 groups. Mean Age was 28.83 +/- 12.47 years (6-51yrs) and 18.25 +/- 8.19 years (6-30yrs) in virgin and manipulated study groups respectively. Mean Pre-op Deviation was 15-45 PD in Virgin group and 15-40PD in manipulated group. Mean post operation (Post Op) deviation after 6-month was 0.9 +/- 3.01 PD and 2.08 +/- 4.98 PD in virgin and manipulated group respectively. Results of the study in post op parameters such as variations in deviation of eyes, BCVA and RFN exhibited generally no significant variance between our study groups. In conclusion, because of insignificant difference between 2 groups, we suggest surgery on manipulated muscles due to less risk of anterior segment ischemia and less conjunctival manipulation that, potentially leads to less dry eye complications.