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Adjustable strabismus surgery can increase the success rate of surgical correction of strabismus

To improve the success rate of strabismus surgery, the Ophthalmology care team of Chiayi Christian Hospital has consecutively developed several advanced surgeries, including adjustable strabismus surgery, nasal transposition of lateral rectus surgery, pull-string adjustable strabismus surgery, and fascia lata augmented lateral rectus transposition surgery, etc.

Adjustable strabismus surgery can increase the success rate of surgical correction of strabismus
In normal newborns, their eyes continue to grow until they reach the size of adult eyes at around the age of 13. Their vision also gradually develops after birth and becomes mature at the age of 10. Most children take the visual acuity test at age 4. However, objective examination can detect several neonatal visual problems such as refractive error, strabismus, congenital cataract, and congenital ptosis, etc. at early stages. Vision screening assessments in infants and young children enable the early detection of developmental disorders of vision, and provide the opportunities for early visual intervention and correction, as well as higher treatment success rate.
 
Dr. Chong-Bin Tsai, Vice President of Chiayi Christian Hospital, said that the objectives for vision screening in infants and young children are to detect developmental disorders of vision that may lead to amblyopia. Common developmental disorders of vision include severe refractive errors (e.g. severe hyperopia, high myopia, and astigmatism), strabismus, and form vision deprivation (e.g. congenital cataract or ptosis). The first consideration for the treatment of amblyopia is to ameliorate the visual developmental disorders. Another consideration is to stimulate the neurogenesis in the eyes with amblyopia. Vice President Tsai said that, the prevalence rate of strabismus in Taiwan was approximately 4%. Common treatment for strabismus includes prism correction, botulinum toxin injection, and traditional strabismus surgery (loosening or tightening the extraocular muscles). However, traditional strabismus surgery often carries high risks of over-correction or under-correction. Meanwhile, the fine control of eye movement by several extraocular muscles is precise and complicated, and anesthesia during surgery may also change the tension of extraocular muscles. Collectively, these risks and limitations indicate that traditional strabismus surgery is usually associated with extremely high surgical difficulties.
 
To improve the success rate of strabismus surgery, the Ophthalmology care team of Chiayi Christian Hospital has consecutively developed several advanced surgeries, including adjustable strabismus surgery, nasal transposition of lateral rectus surgery, pull-string adjustable strabismus surgery, and fascia lata augmented lateral rectus transposition surgery, etc. According to a survey in 2013, in the United States, only 25% of the ophthalmologists can perform adjustable strabismus surgery, and the application of such strabismus surgery in children was relatively rare. For all children with strabismus, the Ophthalmology care team of Chiayi Christian Hospital has developed pull-string adjustable strabismus surgery that largely reduced the difficulty of post-operative adjustment. Such adjustable strabismus surgery has been successfully applied in 123 cases of strabismus surgery in children. The success rate in the correction of strabismus was 76%, which was comparable to the success rate of 74 to 79% of the surgery performed by foreign peers.
 
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