PURPOSE
To determine whether satisfactory results of both eyelid surgery and strabismus surgery can be obtained when these procedures are performed in the same setting in selected patients.
METHODS
Nine patients (16 eyelids) who had undergone surgery in the same setting for eyelid malposition and strabismus of the horizontal rectus muscles, with or without concurrent vertical rectus muscle surgery, were retrospectively reviewed. Eyelid malposition surgery success was defined as a postoperative margin reflex distance (MRD1) within 1 mm of the target. Strabismus surgery success was defined as a postoperative deviation within 8 prism diopters of orthophoria or a decrease in binocular diplopia if the patient had a less than 8 prism diopters deviation in primary gaze preoperatively.
RESULTS
Eyelid retraction repair was performed on 13 upper eyelids, levator advancement was performed on 2 eyelids, and frontalis suspension was performed on 1 eyelid. Four patients underwent bilateral medial rectus recession and the remaining 5 patients received varying strabismus surgery. Four patients received adjustable sutures. Mean follow-up was 11 months. Postoperatively, 13 of 16 eyelids (81%) achieved an MRD1 within 1 mm of the target. Eight of 9 patients (89%) demonstrated satisfactory strabismus correction.
CONCLUSION
Combined eyelid malposition and strabismus surgery can be successfully performed in selected cases, particularly when the strabismus surgery involves the horizontal rectus muscles. Combined surgery is not recommended in cases that do not involve the horizontal rectus muscles.
[J Pediatr Ophthalmol Strabismus 2008;45:220-224.]
AUTHORS
From the Department of Ophthalmology (MSM), University of Colorado Health Sciences Center, Denver, Colorado; the Division of Ophthalmic Facial Plastic and Reconstructive Surgery (JDD, DOK); University of California–San Diego Thyroid Eye Center (DBG, LL, DOK); and the Division of Pediatric Ophthalmology and Strabismus (DBG), Department of Ophthalmology, University of California–San Diego, La Jolla, California.
Originally submitted September 14, 2006.
Accepted for publication July 6, 2007.
Presented as a poster at the American Society of Ophthalmic Plastic and Reconstructive Surgery Annual Fall Scientific Symposium in Orlando, Florida, October 18-19, 2002.
Address correspondence to Michael S. McCracken, MD, Colorado Laser Surgeons, 55 Madison Street #300, Denver, CO 80206.
Drs. McCracken, del Prado, Granet, Levi, and Kikkawa have disclosed no relevant financial relationships.
