Corneal tomography changes following major (6 mm) medial rectus muscle recession: a prospective cohort study using Pentacam®.

INTRODUCTION: The aim of this study is to evaluate changes in corneal astigmatism, axial anterior corneal curvature, as well as changes in the anterior chamber depth and central corneal thickness, 2 months following the unilateral recession of medial rectus muscle in children. METHODS: Thirty-three children with esotropia were prospectively evaluated following unilateral medial rectus muscle recession, using Pentacam®. Comparisons were made between the operated and fellow unoperated eyes, pre, and postoperatively. The assessment was made for changes in the radius of axial curvature on major meridians at 3 and 3.5 mm from the optical corneal center in the mid-peripheral zone. Astigmatism changes of the anterior and posterior corneal surface were calculated using vector analysis software (astigMATIC®). ANOVA model was used to examine the interaction between age or central corneal thickness and postoperative changes in anterior and posterior surface corneal astigmatism. RESULTS: In the intervention group, changes in anterior and posterior corneal surface astigmatism were statistically significant, with a mean increase of 0.59Dx92 and 0.08Dx91, respectively. In the mid-peripheral corneal zone, there is an increase in the radius of anterior corneal axial curvature more evident nasally 3.5 mm from the corneal center on the horizontal meridian, with corresponding decrease superiorly and inferiorly at 3 and 3.5 mm from the corneal center on the vertical meridian. DISCUSSION: The changes in total astigmatism of the operated eyes are mainly attributed to the anterior corneal surface. These changes are associated with flattening in the 180 meridian of the cornea, leading to a shift to "with-the-rule" astigmatism.

Foveal Hypoplasia in a Child With Tyrosinase-Positive Albinism.

The purpose of this article is to report a case of bilateral foveal hypoplasia in an eight-year-old girl who presented to the ophthalmology department due to poor vision in both eyes. Clinical examination revealed bilateral nystagmus, decreased vision, as well as iris transillumination. Dilated fundus examination indicated the absence of light reflex around the foveal area and optical coherence tomography (OCT) imaging exhibited the absence of the fovea centralis depression. These findings, in addition to the patient's light-colored hair and skin complexion, raised suspicion for albinism. The patient was referred for genetic testing and the results confirmed the diagnosis of tyrosinase-positive oculocutaneous albinism (OCA2).

Evaluation of Macular Thickness Changes Following Large Horizontal Rectus Muscle Recession: A Prospective Cohort Study.

Aim The aim of the study was to evaluate the long-term effect of large horizontal rectus muscle recession on macula thickness using spectral domain optical coherence tomography (SD-OCT). Material and methods Forty-two children were included in the study. The intervention groups were the medial rectus (MR) group (=20 eyes ) and the lateral rectus (LR) group (=22 eyes), including the eyes that underwent large medial and lateral rectus muscle recession, respectively. The control group included the fellow 42 unoperated eyes of the same children. Each eye was scanned using Topcon Maestro2 OCT-Angiography (OCTA; Topcon, Tokyo, Japan) preoperatively and then two months following surgery. A paired t-test was used to compare the mean difference in macular thickness between the intervention and control groups using the statistical program R (R Foundation for Statistical Computing, Vienna, Austria). Results The mean change in central, parafoveal, and perifoveal macular thickness of the intervention group was not statistically significant. Conclusion The long-term changes in macular thickness, as evaluated using SD-OCT both for the central and peripheral regions of the fovea, following large horizontal rectus muscle recession surgery, are not statistically significant.

Orbital Rhabdomyosarcoma Masquerading as a Dermoid Cyst: A Case Report and Review of the Literature.

The purpose of this report is to present a case of orbital rhabdomyosarcoma (RMS) masquerading as a dermoid cyst. A six-year-old boy with an unremarkable medical history presented in the outpatient department with a palpable mass in the superonasal region of the right orbit, which had rapidly grown in the past month. The most likely diagnosis was dermoid cyst and the patient was scheduled for surgical excision. A high index of suspicion was raised intraoperatively based on the appearance of the lesion due to the presence of a feeder vessel. The histopathology examination identified alveolar RMS. The patient was referred to a pediatric oncology department and commenced intravenous chemotherapy. RMS may masquerade as various conditions, including dermoid cysts and chalazion. A high index of suspicion should be raised in cases with rapidly growing lesions.

Changes in astigmatism after horizontal muscle recession strabismus surgery: A retrospective cohort study.

Purpose: The aim of this study was to evaluate the changes in astigmatism after unilateral recession of horizontal rectus muscles in pediatric patients. Methods: The authors retrospectively evaluated the medical history of 52 children with esotropia or exotropia, that underwent a unilateral recession strabismus surgery. The intervention group consisted of the 52 eyes that underwent strabismus surgery, and the control group consisted of the other 52 fellow unoperated eyes of the same participants. The intervention group was divided into medial and lateral rectus muscle subgroups, and four subgroups based on the astigmatism axis preoperatively (A: with-the-rule astigmatism, B: no astigmatism, C: intermediate meridians, D: against-the-rule astigmatism). All patients were examined one day preoperatively, and then, six weeks postoperatively. Paired tests were conducted, and the significant level was set to 0.05 or was adjusted for subgroups. Results: A mean difference 0.43 D of astigmatism (95% CI: 0.27, 0.59) was observed after the surgery between intervention and control group (P < 0.001). Astigmatism change (postoperative - preoperative) in subgroup A was 0.50 D (P < 0.001) and in subgroup B was 0.75 D (P < 0.001). Moreover, astigmatism changes of 0.50 D were found in both lateral (P < 0.001) and medial rectus muscle group (P = 0.002). Conclusion: Strabismus surgery appears to be associated with alterations in astigmatism, and in particular increase in cylindrical power in the eyes that had with-the-rule astigmatism or no astigmatism preoperatively. Those changes should be considered when planning the operation, to avoid transforming clinically non-significant astigmatism into clinically significant.