Palpebral fissure widening after different types of strabismus surgery

Objectives: Strabismus surgery may be associated with postsurgical complications such as palpebral fissure widening. For a better understanding of this finding, we studied the surgical outcome of patients undergoing strabismus surgery at our center and its effect on palpebral fissure alterations.

Methods: In this cross-sectional study, 58 patients who underwent strabismus surgery at Amir–Almomenin Hospital, Rasht, Iran during March 2015-2016 were investigated for the changes in eye deviation and palpebral fissure height (PFH) 1 and 3 month(s) after surgery compared with the pre-surgical status. Also, their corneal light reflex of upper eyelid margin to reflex distance (UMRD) and lower eyelid margin to reflex distance (LMRD) was clinically evaluated.

Results: Evaluation of 97 eyes of 58 patients (47 left and 50 right eyes; 63.8% women; mean age of 19.7±13.8 years) undergoing strabismus surgery showed significant changes in deviation, PFH, and LMRD, 1 and 3 month(s) after surgery compared with the pre-surgical status with significant differences based on the type of surgery. Correction of deviation had a significant effect on PFH change (3 months after surgery compared with baseline) in medial and lateral rectus recession techniques (P<0.001).

Conclusion: The results of this study showed significant effect of medial and lateral rectus recession on PFH, UMRD, and LMRD, which emphasizes on the need to inform patients about the possibility of such changes after surgery and search for intra-operative strategies to reduce such changes.