Strabismus surgery is a surgical procedure that involves adjusting the extraocular muscles to correct eye misalignment (strabismus) and improve binocular visual function. This surgery achieves coordinated eye movement by adjusting the length, position, or tension of the eye muscles, aiming for proper visual axis alignment and stereopsis. Suitable candidates include those with congenital strabismus, acquired misalignment due to trauma or neurological injury.
The surgery is primarily divided into three types: muscle shortening (shortening specific muscles), muscle relaxation (cutting the muscle tendon), and muscle recession (changing the attachment point). The mechanism involves redistributing muscle forces to restore normal eye movement range and symmetry. Surgeons select appropriate surgical techniques based on the degree of eye deviation and muscle function abnormalities.
The procedure is usually performed under local or general anesthesia. The surgeon makes small incisions on the surface of the eye to operate, with an operation time of approximately 1-2 hours. Postoperative care includes eye patching for protection and regular follow-up to monitor visual recovery. The effects of the surgery typically become apparent over several weeks, with symptoms such as diplopia or dizziness gradually improving.
The procedure is suitable for patients over 10 years old, but severe cases may require surgery after age 3. Surgeons evaluate suitability based on age, type of strabismus, and degree of visual impairment.
The surgery is performed in the operating room, typically as an outpatient procedure. The surgeon uses microsurgical instruments to precisely adjust the muscles, such as posterior recession of the medial rectus or shortening of the lateral rectus, based on the direction of deviation. Precision is measured in millimeters, usually adjusting 1-4 muscles. Postoperatively, antibiotics eye drops are used as prescribed, and strenuous activities are avoided for two weeks.
The success rate of the surgery ranges from 70% to 90%, with lasting effects. Some complex cases may require multiple surgeries to achieve the desired outcome but can significantly improve quality of life.
Short-term risks include postoperative pain, subconjunctival hemorrhage, or corneal injury, which usually resolve within 1-2 weeks. More serious complications include infection, anesthesia-related issues, or overcorrection leading to opposite deviation, with an incidence of less than 5%. Rarely, patients may experience permanent vision loss, usually related to the severity of pre-existing eye conditions.
Contraindications include uncontrolled diabetes, bleeding disorders, or active ocular infections. Preoperative assessments should include detailed examinations of optic nerve function and refractive status, as well as overall health evaluation. Pregnant women and immunocompromised individuals should carefully assess risks.
Surgeries are often combined with visual training, glasses, or contact lens therapy as part of an integrated approach. Postoperative visual therapy (such as amblyopia training) is recommended to enhance binocular coordination. Patients using steroids or anticoagulants should inform their doctor in advance to adjust medication plans accordingly.
Multicenter studies show that 85% of patients achieve orthotropia (deviation less than 8 degrees) at 6 months post-surgery. Long-term follow-up indicates that 90% of patients maintain results beyond 5 years. Children treated during critical periods of visual development are more likely to recover stereopsis effectively.
These alternatives are suitable for mild cases or patients unable to undergo surgery, but their effects are limited and may require long-term use.
Patients should undergo detailed eye examinations, including eye movement, visual acuity, and eye position assessments. Discontinue anticoagulant medications (such as aspirin) 3-7 days before surgery, and follow the surgeon’s instructions for eye cleaning. Those with systemic diseases (e.g., diabetes) should control their condition to a stable state prior to surgery.
How should I handle eye discomfort after surgery?Postoperative mild pain, photophobia, or blurred vision can be relieved with prescribed painkillers and artificial tears. If severe redness, intense pain, or sudden vision loss occurs, seek medical attention immediately to rule out infection or bleeding complications.
When can normal eye use resume after surgery?Generally, rest for 1-2 weeks is recommended, avoiding strenuous activities and heavy lifting to prevent suture loosening. Limit reading and screen time to no more than 2 hours daily, with a 5-minute break every half hour. Full recovery of eye muscle coordination usually takes 1 to 3 months, with regular follow-up for adjustments.
What factors influence the success rate of the surgery?The success rate depends on the severity of the condition, surgical skill, and postoperative compliance. Patients with congenital strabismus treated during childhood tend to have better correction outcomes. Adults with long-standing deviations may require multiple surgeries for optimal results.
Will the deviation recur after surgery?Approximately 5-10% of patients may experience recurrence due to fibrosis of the eye muscles or nerve control abnormalities. Regular follow-up is necessary, and if the deviation exceeds 10 degrees, the doctor may recommend wearing eye patches or performing secondary adjustments.
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