Comparison of Minimally Invasive Strabismus Surgery (MISS) and Conventional Strabismus Surgery Using the Limbal Approach

Abstract

Purpose: To compare minimally invasive strabismus surgery (MISS) with conventional strabismus surgery for horizontal recti in terms of functional outcome and complications.

Methods: A total of 40 patients requiring surgery for horizontal recti were divided into two groups: those undergoing MISS and those operated on using the conventional limbal technique. In the MISS group, two small keyhole radial cuts were made superior and inferior to the insertion of the muscle margin. Keyhole cut size was almost 1 mm less than the amount of muscle recessed or resected.

Results: There were significant differences in conjunctival redness and swelling in both groups on postoperative days 1 and 7 and week 3. However, after the third week, both groups had a similar appearance. Visual acuity was decreased at postoperative day 1 in both groups, but the difference was not significant. No significant differences were found for final alignment, binocular single vision, other visual acuities, refractive changes, or complications.

Conclusions: This study shows that this new, small incision, minimal dissection technique is feasible. The MISS technique seems to be superior in the immediate postoperative period because there were fewer conjunctival and eyelid swelling complications. Long-term results did not differ between the two groups. [J Pediatr Ophthalmol Strabismus. 2017;54(4):208-215.].