REFRACTIVE CHANGES INDUCED BY STRABISMUS CORRECTIVE SURGERY IN ADULTS

Abstract

Objective: To examine the refractive alterations that occur in adults following strabismus repair techniques.

Study Design: descriptive case series study.

Place and Duration of Study: This Study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from January 2025 to June 2025.

Methods: Adult patients who underwent surgery on the horizontal recti muscles, including measurements of cycloplegic refraction before and after the procedure were included. After subtracting the preoperative refraction from the postoperative refraction mathematically, the caused refractive alterations were examined statistically. The toric change's magnitude was investigated using vector analysis. Additionally, assessed was the percentage of clinically meaningful refractive change. The difference between each postoperative refraction and the matching preoperative refraction was evaluated using the paired t-test in order to evaluate the medically caused refractive alterations. A clinically meaningful change in refractive power was defined as one of 0.5 D or greater. To determine if the percentage of clinically significant changes exceeded an acceptable 10%, a one-sample binomial test was employed. The IBM SPSS statistics 27.0 program was used. P values below 0.05 were regarded as statistically significant.

Results: The final analysis included 31 eyeballs from 22 patients who satisfied the requirements. After surgery, the astigmatism changed in the with-the-rule direction and the spherical equivalent changed a lot toward myopia.  In comparison to the one-month postoperative test, a third cycloplegic refraction assessment indicated stable refraction in a group of nine people. Clinically significant (≥0.5 D) surgically induced refractive shift was observed in 40.9% of patients.

Conclusions: One major adverse effect of corrective surgery for horizontal strabismus in adults is refractive alterations. As a result, patients ought to be made aware of it before surgery and reconsidered throughout the recovery phase.