A Review of Minimally Invasive Strabismus Surgery (MISS): Is This the Way Forward?

Asproudis, Ioannis; Kozeis, Nikolaos; Katsanos, Andreas; Jain, Saurabh; Tranos, Paris; Konstas, A. G. P.

doi:10.1007/s12325-017-0498-7

Cited by 10 publications

(3 citation statements)

References 21 publications

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“…MIS in the strabismus field has been developed to reduce the conjunctival congestion and chemosis, perimuscular tissue scarring and damage, and preservation of perilimbal episcleral vessels. 7 We prepared the current article to review available MIS techniques in the strabismus field.…”

Section: Introductionmentioning

confidence: 99%

Minimal Invasive Procedures in Strabismus Surgery: A Narrative Review

Mojon,

Kiarudi,

Sabermoghaddam

et al. 2023

Journal of Current Ophthalmology

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Purpose: To review the principles and different techniques of minimally invasive procedures in strabismus surgery. Methods: This is a narrative review on minimally invasive procedures in strabismus surgery including general aspects and different new modifications on conventional strabismus surgery. We reviewed 24 articles published between 1993 and 2020. Results: Minimal invasive procedures could be categorized into two subsets: one which minimizes conjunctival opening size and another which minimizes the muscle manipulations. Different conjunctival approaches have been introduced, such as Cul-de-sac and minimally invasive strabismus surgery incisions. Furthermore, there are different techniques for extraocular muscle weakening, strengthening, and transposition, such as mini-tenotomy, plication, mini-plication, Nishida, and modified Nishida procedures. Moreover, there are some techniques for handling strabismus in heavy eyes with high myopia and using adjustable sutures for strabismus correction. Conclusions: Minimally invasive procedures in strabismus surgery consist of surgical procedures that minimize tissue disruption, speed up rehabilitation, and often ultimate better outcomes. These techniques could be replaced traditional methods to reduce conjunctival and lid swelling in the direct postoperative period.

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Section: Introductionmentioning

confidence: 99%

Minimal Invasive Procedures in Strabismus Surgery: A Narrative Review

Mojon,

Kiarudi,

Sabermoghaddam

et al. 2023

Journal of Current Ophthalmology

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“…They are planned preoperatively based on the expected extent of exposure needed for the specific surgery to achieve optimal cosmetic and functional results. [ 3 ] The incisions have evolved from Harm's limbal approach,[ 6 7 8 ] Park's fornicial approach,[ 9 ] Velez's radial incision,[ 10 ] Swan's incison,[ 7 8 11 ] to the minimally invasive strabismus surgery (MISS) popularized by Mojon. [ 12 13 14 15 ] Like other subspecialties of ophthalmology, strabismus surgery also strives to be less invasive and time efficient, permitting early ambulation, achieving better cosmesis and comfort postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Single-snip paralimbal incision

Saxena

Akhtar

Gupta

et al. 2021

Oman Journal of Ophthalmology

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INTRODUCTION: Less invasive and quicker surgeries have become common. We compared two conjunctival incisional approaches in strabismus, namely Follow standard paralimbal approach for (SPLA) and single-snip paralimbal (SSPLA). MATERIALS AND METHODS: Forty-four patients with horizontal strabismus qualifying for uniocular recession–resection surgeries were randomized to SPLA and SSPLA. SSPLA involved a single v-shaped incision, with the apex of the V near the limbus, and the limbs facing away: by pinching up the conjunctiva with a forceps and delivering the single snip with a spring scissors. We compared the postoperative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6–8 weeks; scar visibility, as yes or no, at 6–8 weeks; success rates, considered to be within 10 prism diopters of orthophoria, at 6–8 weeks; and operation duration in minutes. STATISTICAL ANALYSIS: Statistical analysis was done using Mann–Whitney U-test, for inflammatory grades, Chi-square for proportions, and t-test for parametric measures. Statistical significance was set at P < 0.05. RESULTS: On postoperative day 1, congestion (P = 0.02), foreign-body sensation (P = 0.04), and total inflammatory score (P = 0.003) were statistically significantly favoring the SSPLA group. While at 2 weeks, only congestion (P = 0.02) was found to be significantly less in the SSPLA group. There were no significant differences in the proportions of scar visibility (5/22 in the SPLA vs. 3/22 in the SSPLA) and success rate: 20/22 vs. 18/22. The SSPLA was quicker on an average by 6 min (P < 0.001, 95% confidence interval: 3.2–8.7). CONCLUSION: Compared to the SPLA, the SSPLA is quicker and results in lesser inflammation in the immediate postoperative period.

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“…Combined with glasses, prisms-wearing, and visual training before and after surgery, strabismus surgery creates the opportunity of building and restoring binocular vision function and eventually improves the possibility of increasing of visual acuity, or even patients' quality of life [ 7 , 8 ]. Strabismus surgery is also called extraocular muscle surgery; it is a minimally invasive surgery under direct vision, with limited complications and quick recovery [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Descriptive Study of Conjunctival Cysts: A Rare Complication after Strabismus Surgery

Min

Jiang

Shi

2018

Journal of Ophthalmology

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Aim Conjunctival cyst is one of the uncommon complications of strabismus surgery. It is important for surgeons and patients to be aware of and take precautions to minimize the risk. This study aimed to explore the clinical manifestations, etiology, and prognosis of conjunctival cyst at the operative site after strabismus surgery. Methods The data of 1675 patients were included in our retrospective analysis, who underwent strabismus surgery at the Xiangya Hospital of Central South University between 2010 and 2016. During the postoperative follow-up, conjunctival cyst was found in 7 cases (7 eyes; 0.4% detective rate of all cases). The clinical characteristics, prognosis, and follow-up data were recorded together with the results of pathological and bacteriological tests. Results Seven patients between the age of 3 years 8 months and 39 years, with the mean age of 12.71 years (12.71 ± 12.59, years of age), were included in the study. Strabismus surgery affected 13 recti, 8 medial and 5 lateral recti, and 3 obliques (all inferior oblique). Conjunctival cyst was detected in seven patients between 10 days and 6 months postoperatively (42.57 ± 61.11, detected days). In six cases, the cyst was detected at the nasal (3 cases) or temporal side (other 3 cases), and at the fornix in one case. Four out of 7 patients underwent cyst excision, and methicillin-resistant Staphylococcus aureus (MRSA) was detected in one patient. Conclusions Conjunctival cyst is a rare postoperative complication of strabismus surgery, conjunctival epithelium implantation should be the primary cause, and infection might exaggerate the situation. A longer duration of the surgical procedure could increase the possibility of infection, which could be accompanied with a greater tendency to the occurrence of conjunctival cyst.

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A Review of Minimally Invasive Strabismus Surgery (MISS): Is This the Way Forward?

Cited by 10 publications

References 21 publications

Minimal Invasive Procedures in Strabismus Surgery: A Narrative Review

Minimal Invasive Procedures in Strabismus Surgery: A Narrative Review

Single-snip paralimbal incision

Descriptive Study of Conjunctival Cysts: A Rare Complication after Strabismus Surgery

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