One vs two muscle surgery results for small / moderate angle horizontal strabismus
Reviewed by Fiona Rowe

The authors aimed to compare the long-term surgical outcomes of one vs two muscle surgery in 89 patients with horizontal strabismus of small to moderate angle (<25PD). This was a retrospective study with a minimum six-month follow-up period. One muscle surgery (group 1) was undertaken in 17 (mean age 14.12 ±9.30 years) and two muscles (group 2) in 72 cases (mean age 11.70 ±11.30 years). There were no significant differences in groups for age, gender, visual acuity, angle of deviation and presence of amblyopia. Refractive error was significantly higher in group 1 but was non-significant after adjustment for previous surgeries. At final follow-up, there was no significant difference between groups for refraction, visual acuity and angle of deviation, with similar follow-up periods for both groups. Similar surgical success rates were found for small vs larger deviations, or whether esotropia or exotropia. Overall, results were comparable and long-term surgical success was 70.60% for group 1, and 68.10% for group 2. These results suggest one muscle surgery is as safe and effective for small angle horizontal strabismus as two muscle surgery.

Long-term surgical outcomes of one-muscle vs two-muscle horizontal strabismus surgery.
Ibrahim HA, Pharm AS, El Hadi D, Al-Haddad C.
STRABISMUS
2024;32(2):65–72.