Endophthalmitis after strabismus surgery: incidence and outc
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Medical action is and will always be associated with a certain risk. This also applies to strabismus surgery. One should not be misled by the fact that grave complications after strabismus surgery are, fortunately, very rare and one should not refer to strabismus operations as being almost risk free. A study was conducted to identify risk factors for endophthalmitis after strabismus surgery (EASS) and relate these to incidence and outcome.

None of the 26 patients (27 eyes with EASS) were between 9 and 65 years old, except for one patient with retinal hemorrhage followed by endophthalmitis. Endophthalmitis was diagnosed on postoperative day 1–4 in children aged 0–3. In all 15 children aged 0–5, the 16 affected eyes were phthisical, eviscerated or enucleated. The involved eye muscle had been recessed in 25 of 27 cases. It was a medial rectus in 15 of 16 children aged 0–6. It was a lateral, inferior, or medial rectus in the elderly. Scleral perforation went unnoticed in all children (no record in three) and in two of seven elderly. Histopathology showed transscleral scarring compatible with scleral perforation in four patients but, in a two year old girl who had EASS together with a transient medial rectus palsy, the sclera underneath the former suture tract was not perforated but did contain the long posterior ciliary artery.

Endophthalmitis after strabismus surgery (EASS) affects children and the elderly, with a grave outcome in young children. It occurs after the recession of the medial rectus muscle in children, and it may occur without scleral perforation. Age and perforation influence many other parameters that determine the occurrence and fulminance of EASS.

Source: https://onlinelibrary.wiley.com/doi/full/10.1111/aos.14446?af=R