Corneal Curvature Change After Strabismus Surgery: An Experience from a Single-academic Center

Thammanoon  Surachatkumtonekul; Sasima  Tongsai; Kanchalika  Sathianvichitr; Prapasson  Sangsre; Manatsawin  Saiman; Wasawat  Sermsripong; Piyaphat   Jaruniphakul

doi:10.33192/smj.v76i10.268910

Authors

Thammanoon Surachatkumtonekul Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Sasima Tongsai Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Kanchalika Sathianvichitr Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Prapasson Sangsre Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Manatsawin Saiman Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Wasawat Sermsripong Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Piyaphat Jaruniphakul Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v76i10.268910

Keywords:

Strabismus, refractive error, cornea, astigmatism, strabismus surgery, corneal topography, spherical aberration

Abstract

Objective: This study aimed to explore corneal curvature changes following strabismus surgery using a quadric surface fitting model to address ocular misalignment.

Material and Methods: In this prospective cross-sectional study, 54 completed cases (84 eyes) of patients aged 6–60 years old (mean 10 years old) undergoing horizontal rectus muscle surgery were examined using placido-based keratometry with the Oculus Keratograph 5M system. Data on corneal curvature were collected one week pre-operation, and again one week, one month, and three months post-operation. Asphericity in the vertical meridian (Qy) and horizontal meridian (Qx), and surgical-induced astigmatism (SIA) were calculated.

Results: The 84 eyes included were categorized into three groups: horizontal muscle surgeries, oblique muscle surgery, and combined horizontal and oblique muscle surgeries. Significant corneal prolation (steep central, flat peripheral) was revealed in the vertical meridian (Qy) at 3 months postoperatively for lateral rectus (LR) recession in the first group (p < 0.001), and the mean SIA was 0.45 D (95% CI: 0.35–0.56 D). A similar effect was seen in the vertical meridian of the third group (p < 0.01), with a mean SIA at 3 months of 0.27 D (95% CI: 0.23–0.32 D).

Conclusion: Lateral rectus muscle recession induces corneal vertical prolation for up to 3 months post-operation. Surgeons are thus advised to re-evaluate refraction and defer contact lens refitting, refractive surgery, and intraocular lens calculations for at least 3 months after the procedure.

References

Donnenfeld E, Rosenberg E, Boozan H, Davis Z, Nattis A. Randomized prospective evaluation of the wound integrity of primary clear corneal incisions made with a femtosecond laser versus a manual keratome. J Cataract Refract Surg. 2018;44(3):329-35.

Alvani A, Pakravan M, Esfandiari H, Safi S, Yaseri M, Pakravan P. Ocular Biometric Changes after Trabeculectomy. J Ophthalmic Vis Res. 2016;11(3):296-303.

Cetin E, Ozbek Z, Saatci AO, Durak I. The effect of scleral buckling surgery on corneal astigmatism, corneal thickness, and anterior chamber depth. J Refract Surg. 2006;22(5):494-9.

Zinkernagel MS, Ebneter A, Ammann-Rauch D. Effect of Upper Eyelid Surgery on Corneal Topography. Arch Ophthalmol. 2007;125(12):1610-2.

Kim YK, In JH, Jang SY. Changes in Corneal Curvature after Upper Eyelid Surgery Measured by Corneal Topography. J Craniofac Surg. 2016;27(3):e235-8.

Shammas HJ, Shammas MC. No-history method of intraocular lens power calculation for cataract surgery after myopic laser in situ keratomileusis. J Cataract Refract Surg. 2007;33(1):31-6.

Klijn S, Sicam VA, Reus NJ. Long-term changes in intraocular lens position and corneal curvature after cataract surgery and their effect on refraction. J Cataract Refract Surg. 2016;42(1):35-43.

Jeong J, Song H, Lee JK, Chuck RS, Kwon JW. The effect of ocular biometric factors on the accuracy of various IOL power calculation formulas. BMC Ophthalmol. 2017;17(1):62.

Schworm HD, Ullrich S, Hoing C, Dittus C, Boergen KP. Original papers: Does strabismus surgery induce significant changes of corneal topography? Strabismus. 1997;5(2):81-9.

Rajavi Z, Mohammad Rabei H, Ramezani A, Heidari A, Daneshvar F. Refractive effect of the horizontal rectus muscle recession. Int Ophthalmol. 2008;28(2):83-8.

Noh JH, Park KH, Lee JY, Jung MS, Kim SY. Changes in refractive error and anterior segment parameters after isolated lateral rectus muscle recession. J AAPOS. 2013;17(3):291-5.

Nardi M, Rizzo S, Pellegrini G, Lepri A. Effects of strabismus surgery on corneal topography. J Pediatr Ophthalmol Strabismus. 997;34(4):244-6.

Bagheri A, Farahi A, Guyton DL. Astigmatism induced by simultaneous recession of both horizontal rectus muscles. J AAPOS. 2003;7(1):42-6.

Al-Tamimi E, Al-Nosair G, Yassin S. Effect of Horizontal Strabismus Surgery on the Refractive Status. Strabismus. 2015;23(3):111-6.

Bae SH, Choi DG. Changes of corneal topographic measurements and higher-order aberrations after surgery for exotropia. PloS One. 2018;13(8):e0202864.

Parks, Marshall M. Atlas of Strabismus Surgery. Harper and Row Publishing, Philadelphia, 1983.

Yury (2023). Ellipsoid fit (https://www.mathworks.com/matlabcentral/fileexchange/24693-ellipsoid-fit), MATLAB Central File Exchange. Retrieved December 24, 2023.

Villegas EA, Alcón E, Artal P. Minimum amount of astigmatism that should be corrected. J Cataract Refract Surg. 2014;40(1):13-9.

Di Y, Li MY, Qiao T, Lu N. Edge detection and mathematic fitting for corneal surface with Matlab software. Int J Ophthalmol. 2017;10(3):336-42.

Theodoulidou S, Asproudis I, Kalogeropoulos C, Athanasiadis A, Aspiotis M. The role of sideport incision in astigmatism change after cataract surgery. Clin Ophthalmol. 2015;9:1421-8.

Alpins N, Ong JK, Stamatelatos G. Corneal coupling of astigmatism applied to incisional and ablative surgery. J Cataract Refract Surg. 2014;40(11):1813-27.

Killer HE, Bähler A. Significant immediate and long-term reduction of astigmatism after lateral rectus recession in divergent Duane's syndrome. Ophthalmologica. 1999;213(3):209-10.

LaMattina KC, DeBenedictis CN. Refractive changes after strabismus surgery. Curr Opin Ophthalmol. 2016;27(5):393-7.

Kwitko S, Feldon S, McDonnell PJ. Corneal topographic changes following strabismus surgery in Grave's disease. Cornea. 1992;11(1):36-40.

Eum SJ, Chun BY. Comparison of Astigmatism Induced by Combined Inferior Oblique Anterior Transposition Procedure and Lateral Rectus Recession Alone. Korean J Ophthalmol. 2016;30(6):459-467.

El Gendy HA, Khalil NM, Eissa IM, Shousha SM. The Effect of Strabismus Muscle Surgery on Corneal Biomechanics. J Ophthalmol. 2018;2018:8072140.