Strabismus means virtually ANY lack of parallelism in the eyes. The causes can be multiple. When it appears in a patient who has had straight eyes before, the patient may have double vision (diplopia). The cause can be congenital or acquired: high dioptres, amblyopia or a neurological disease, a tumour, an endocrine imbalance, an exaggerated and prolonged exposure to the mobile phone and many others. The strabismus operation has two purposes: functional and aesthetic.
We use a unique surgical technique in Romania that involves extremely small incisions, with very fast healing and without scars. Strabismus operations are performed under conditions of general anaesthesia for both children and adults.
In some situations, we use local or topical anaesthesia (drops) only in adults.
What is the operation about?
Warning! The intervention for strabismus is delicate and requires a surgeon specialized in this type of surgery, otherwise the failure to know all aspects results in unwanted and sometimes irreversible results.
The surgery technique consists in the weakening of the hyperactive muscles (retroposition) and / or the strengthening of the hypoactive muscles (shortening, advancing or folding). The technique used in OFTAPRO involves small incisions (3-4 mm), which is why recovery is very fast.
There are also more complicated surgeries, especially for less common strabismus, where more muscles need to be operated or more complicated surgical techniques other than those mentioned are used, that only certain surgeons can perform. The decision belongs entirely to the strabismus doctor specialist and the pre-surgery plan can be modified during the intervention according to the findings during the intervention.
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What is the optimal age for strabismus surgery?
The optimal age for surgery depends on the age of onset of strabismus.
• Congenital strabismus – which occurs in the first 6 months of life – surgery should be performed as soon as possible, even under the age of 1 year, otherwise the child no longer develops normal binocular vision. All studies indicate better functional outcomes in children under 24 months of age. It may take two or three surgeries until perfect alignment is obtained.
• Strabismus that appeared later – after the exhaustion of other forms of treatment: glasses, occlusion – if the deviation persists – switch to surgical treatment. It is ideal for this surgery to be performed before the age of 4 and a half, but the shorter the imbalance period (between the appearance of strabismus and surgery), the better the results.
Is another surgery required?
If the strabismus angle is large, in paralytic or thyroid strabismus – after a first surgery it may be necessary to correct the remaining angle, so a second surgery, performed on other muscles, without this fact representing a failure of the first surgery.
The surgery is performed under general anaesthesia, under conditions of perfect sterility. After the surgery, children go home without a bandage, as do most adults. After more complex operations, it may be required to wear a bandage for a few days.
The first postoperative check-up is done the next day.
What risks and complications can occur?
In any surgery there are -theoretically- risks of anaesthesia and surgery. In the strabismus operation the risks are minimal:
- Diplopia (double vision) after the operation is transient in 99% of cases
- Postoperative infections are prevented by drops with antibiotics, anti-inflammatory and strict maintenance of eye and hand hygiene. It manifests itself with: swollen eyelid, red eyes, muco-purulent secretion and may progress to cellulite.
- Intraoperative incidents may be prevented by means of a correct surgical technique.
- Supra or sub-corrections of the strabismus angle that require another intervention. The risk is higher in case of complex, high-angle strabismus and in case of those with onset under the age of 6 months. Sometimes the surgical treatment has to be performed in stages due to the particularities of the case.
Do you use the laser in strabismus surgery?
Warning! The laser shall NOT be used in strabismus surgery because it has no application. The laser is used in ophthalmology for other types of surgery in which you have to remove certain tissues. In the strabismus surgery all tissues must maintain their structure and integrity for a functional result and to allow re-intervention.
Statements such as “laser-operated strabismus” are misleading, most often for commercial purposes.