PurposeTo determine our rate of conjunctival cyst developing after strabismus surgery and to minimize its formationMaterials and MethodsThe data of 4026 eyes of 2662 patients were included in our retrospective analysis of, those that underwent strabismus surgery at the Beyoglu Eye Training and Research Hospital Strabismus Unit between 2015 and 2021. Clinical characteristics and follow-up data of patients were recorded together with age, sex, and operation type. All patients were examined postoperatively on 1st day, 1st month and 6th month.ResultsThe mean age of the patients was 15.66 & PLUSMN; 11.81 (1-59 years). While two eyes were operated on in 1494 patients, one eye was operated on in 1168 patients. The surgeries performed were recession and/or resection of the horizontal and vertical rectus muscles and inferior and superior oblique procedures. The conjunctival cyst was detected in 11 patients postoperatively between 20 days and 8 months. The cyst was detected on the nasal side in 7 cases and temporal in 4.ConclusionConjunctival cyst is a rare complication after strabismus surgery and it is thought to be caused by a proliferation of the conjunctival epithelium. In addition to proper closure of the conjunctiva, attention to personal hygiene, avoidance of contacts that may increase suture contamination, and attention to the fact that the operation period is not long are actions that can help prevent conjunctival cyst formation.

Purpose: To compare macular microvascular changes after horizontal rectus and inferior oblique (IO) muscle surgeries using swept-source optical coherence tomography angiography (OCTA) and to assess the distinct vascular effects of each surgical approach. Methods: Eighty-two pediatric and adolescent patients with concomitant strabismus underwent unilateral extraocular muscle surgery. Group 1 (n = 43) received horizontal rectus muscle surgery; Group 2 (n = 39) underwent IO weakening surgery. The fellow unoperated eye served as a control. Macular microvasculature was evaluated before surgery, at 1 week, and 1 month postoperatively using a swept-source OCTA system. Vessel density (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), as well as the foveal avascular zone area (FAZ), was quantitatively analyzed. Results: In the horizontal rectus group, SCP VD significantly increased in the 1st week compared to baseline (49.97% ± 2.41% vs. 51.16% ± 3.23%, p = 0.037) and returned to baseline values in the 1st month. A transient increase in CC VD was also observed at the 1st week (p = 0.006). No significant changes occurred in the DCP and FAZ. In the IO group, no significant changes were found in the SCP, DCP, or FAZ. However, a mild, transient increase in CC VD was observed at the 1st week (p = 0.001), which returned to baseline by the 1st month. Conclusion: Horizontal rectus muscle surgery induces significant but transient changes in macular retinal and choroidal perfusion. In contrast, IO muscle surgery induces only localized and temporary choroidal alterations. OCTA may therefore serve as a valuable noninvasive tool for postoperative monitoring of vascular alterations in strabismus surgery.

Objectives: To evaluate the effectiveness of the conjunctival suture tied internally and externally on patient comfort and suture dissolution in the postoperative period in patients who underwent symmetrical strabismus surgery. Methods: In 50 patients who underwent surgery in the Beyoğlu Eye Training and Research Hospital Strabismus Unit, the conjunctiva was closed by tying the conjunctival suture externally in the right eye and internally tying the left eye. Absorbable 8/0 polyglactin suture was used for conjunctival suturing in all patients. Pain, itching, tearing and, discomfort sensations of the patients were questioned and a slit-lamp examination for conjunctival inflammation and dissolution of the suture were evaluated on the postoperative 1st day, 1st week, 1st month, and 6th weeks. Results: Twenty-two patients were female and 28 were male. The mean age of the patients was 7.24 ± 4.83 (range: 4-17) years. When the pain, stinging and discomfort of the patients were questioned, 46% of the patients stated that they felt more comfortable in the left eye on the 1st and 10th days, while 48% of the patients stated that they were equal in both eyes. When we evaluated the melting of the suture and conjunctival redness, it was observed that the suture in the left eye was melted prematurely at a rate of 40% and, the conjunctival redness resolved early in the first month. There were equal pain and redness in both eyes at a rate of 54%. Conclusions: In strabismus surgery, the closure of the conjunctiva by tying the suture internally is thought to increase patient comfort in the postoperative period.

Purpose: This study aimed to investigate the types, characteristics, and refractive values of strabismus in individuals under temporary protection who were followed in the strabismus outpatient clinic. Materials and Methods: Patient records from the Beyoğlu Eye Training and Research Hospital Strabismus Unit (2014-2021) were analyzed. Cases involving trauma or cranial nerve paralysis were excluded. Data from 492 patients were reviewed, focusing on strabismus type, accompanying conditions, and refractive status. Results: A total of 492 patients (258 female, 234 male) were included in the study. The mean age of the patients was 7.27±5.93 (1-18). The mean visual acuity of the patients whose visual acuity could be evaluated was 0.1±0.5(0.7-0.0) LogMar for the right eye; 0.2±0.5(1.0-0.0) LogMar for the left eye. The mean spheric refraction values were +2.56±2.82 D in the right eye and, +2.69±3.11 D in the left eye. The mean cylindric refraction values were 0.91±1.10 for the right eye and, 0.93±1.09 for the left eye. Esotropia in 290 (58.9%) patients, exotropia in 178 (36.2%), vertical strabismus in 14 (2.8%), Duane’s syndrome in 9 (1.8%), 3 (0.6%) Brown’s syndrome were detected. Accompanying AHP was present in 42 (8.5%) patients and these were patients with vertical deviation, Duane’s and Brown syndrome and nystagmus. Amblyopia was present in 151 (30.7%) patients and all were strabismic. Nystagmus were detected in 11 patients (2.2%). Conclusion: Esotropia was the most common type of strabismus among the patients, aligning with trends in the general population. Refractive errors also showed similar patterns to the broader population.

Background/Objectives: To evaluate the long-term outcomes of strabismus treatment in children with cerebral palsy (CP) and to investigate factors associated with postoperative alignment success and the development of consecutive strabismus. Methods: The retrospective, single-center study included 73 children with CP and strabismus who were followed from January 2015 to December 2024. Demographic characteristics, ophthalmological findings, treatment methods, and postoperative outcomes were assessed. Ocular deviation was measured through prism and alternate cover testing or a modified Krimsky test, and surgical success was defined as a final deviation of ≤10 prism diopters (PD). Patients were assessed at the patient level. Comparisons between exotropic and esotropic patients and between patients who had consecutive exotropia and those who had successful alignment were made using appropriate statistical tests. Results: Study participants included 55 patients with esotropia (75.3%) and 18 patients with exotropia (24.7%). The mean follow-up period was 32.6 ± 7.18 months. A successful ocular alignment was achieved in 32 of 46 patients (69.6%) with esotropia and in 10 of 17 patients (58.8%) with exotropia following surgical treatment and/or BTA. Consecutive exotropia developed exclusively in patients initially treated for esotropia (39.1% vs. 0%, p = 0.001). Patients with consecutive exotropia underwent surgery at a younger age and had larger preoperative deviation angles than those who had successful alignment, but these differences were not statistically significant. Conclusions: Strabismus treatment provides satisfactory long-term motor alignment in many children with cerebral palsy. However, consecutive exotropia following esotropia surgery remains a common postoperative condition and is the principal source of alignment instability in this population. Younger surgical age and larger preoperative deviations were more common among patients with consecutive exotropia, but no statistically significant associations between the evaluated clinical variables and consecutive exotropia were identified in the exploratory univariate analyses.