Abstract

FR.23.02

A new, transconjunctival suturing technique for minimally invasive strabismus surgery

Daniel Mojon

Abteilung für Strabologie und Neuroophthalmologie, KSSG St. Gallen, St.Gallen, Schweiz

Objective
The term minimally invasive strabismus surgery (MISS) is used for a technique permitting to perform eye muscle surgery using one or more keyhole openings away from the limbus. In order to further decrease the total conjunctival opening size, a new, transconjunctival suturing (TRASU) technique has been developed.
Methods
In this prospective study, the first 20 patients operated on rectus muscles with the TRASU technique were included. Since when performing a scleral anchoring the needle is retracted transconjunctivally, there is no need to open the conjunctiva over the site of muscle reattachment.
Results
Compared to the standard MISS technique, TRASU allowed in the 20 patients to reduce the opening size by 31% ± 11%. Intraoperatively no complications occurred. Postoperatively, 19 patients could be reexamined (95%). 11 out of 19 patients (58%) showed only a minimal conjunctival redness on the first postoperative day. After 6 month, refraction and visual acuity remained unchanged compared to preoperatively (p>0.1 for each).
Conclusions
The TRASU technique allows performing scleral anchoring without need to open the conjunctiva above the site of muscle reattachment. This allows to further reducing the conjunctival opening size by approximately one third compared to the standard MISS technique. Since surgery is more demanding, larger patient series need to confirm that this technique is not associated with a higher risk of scleral penetration.

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