Single-snip paralimbal incision: A quick approach to rectus muscles.

INTRODUCTION

Less invasive and quicker surgeries have become common. We compared two conjunctival incisional approaches in strabismus, namely Follow standard paralimbal approach for (SPLA) and single-snip paralimbal (SSPLA).

MATERIALS AND

METHODS

Forty-four patients with horizontal strabismus qualifying for uniocular recession-resection surgeries were randomized to SPLA and SSPLA. SSPLA involved a single v-shaped incision, with the apex of the V near the limbus, and the limbs facing away: by pinching up the conjunctiva with a forceps and delivering the single snip with a spring scissors. We compared the postoperative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6-8 weeks; scar visibility, as yes or no, at 6-8 weeks; success rates, considered to be within 10 prism diopters of orthophoria, at 6-8 weeks; and operation duration in minutes.

STATISTICAL ANALYSIS: Statistical analysis was done using Mann-Whitney U-test, for inflammatory grades, Chi-square for proportions, and t-test for parametric measures. Statistical significance was set at P < 0.05.

RESULTS

On postoperative day 1, congestion (P = 0.02), foreign-body sensation (P = 0.04), and total inflammatory score (P = 0.003) were statistically significantly favoring the SSPLA group. While at 2 weeks, only congestion (P = 0.02) was found to be significantly less in the SSPLA group. There were no significant differences in the proportions of scar visibility (5/22 in the SPLA vs. 3/22 in the SSPLA) and success rate: 20/22 vs. 18/22. The SSPLA was quicker on an average by 6 min (P < 0.001, 95% confidence interval: 3.2-8.7).

CONCLUSION

Compared to the SPLA, the SSPLA is quicker and results in lesser inflammation in the immediate postoperative period.