Minimally invasive strabismus surgery technique in horizontal rectus muscle surgery for esotropia.

PURPOSE: To evaluate the minimally invasive strabismus surgery (MISS) technique in combined unilateral horizontal rectus muscle operations for esotropia.

METHODS: This study included 61 patients operated by one surgeon with MISS medial rectus muscle recession and lateral rectus muscle plication. Alignment, binocular vision, conjunctival injection and swelling as well as complications during the first 6 postoperative months were recorded prospectively. Conjunctival swelling and injection on postoperative day 1 were scored retrospectively and compared to a study, which included patients operated with a limbal approach.

RESULTS: Conjunctival swelling and injection were less pronounced than following surgery with limbal approach (comparison of swelling and injection: p < 0.001 for MISS vs. limbal opening plication and p < 0.001 for MISS vs. limbal opening resection). A conversion to a limbal opening was necessary in 2.4% of muscles. No scleral perforation or other serious complication was observed.

CONCLUSIONS: This study indicates that MISS induces less conjunctival swelling and injection compared to the usual limbal approach.