Original papers: Complications in strabismus surgery.

Perforation of the globe is a rare but specific risk of strabismus surgery, as proven by a review of the literature and statistic analyses of the authors. While in the 1960s and 1970s perforations occurred in about 10% of the operations, improved operation techniques and better material have reduced the perforation rate to 1%° at present. This tendency is confirmed by the authors' studies of the periods 1966-1970 (eight clinics; 10,349 strabismus operations; 37 perforations = 3.6%°) and 1989-1993 (23 clinics; 44,211 operations; 67 perforations = 1.5%°). The personal perforation rate of the authors (1.2%° of operated eyes) is in good agreement with the results in other clinics with specialized orthoptic departments. Three case reports demonstrate inadvertent perforation of the globe. In one case, intrabulbar steroid injection caused visual loss due to central retinal artery occlusion. The authors therefore recommend postoperative ophthalmoscopy of the fundus periphery with dilated pupils.