This study reports the development of instruments to substitute traction sutures during strabismus surgery and to act in place of surgical assistance. Three types of instruments were developed: (1) fixable multi-functional forceps; (2) fixable muscle hook; and (3) fixable retractor. The authors report the clinical feasibility and significance of these instruments. The instruments were used in surgery for rectus muscles and the inferior oblique muscle. Thirty patients were recruited: 18 male, 12 female aged 3–48 (median 13 years). Four had intermittent exotropia, six constant exotropia, two constant esotropia, two acute concomitant esotropia, two dissociated vertical divergence, 11 exotropia with V pattern, one esotropia with V pattern and two unilateral superior oblique palsy. Mean operative time for one lateral rectus was 9.88 ±1.59mins, for one medial rectus 10.59 ±2.38 mins, and for one inferior oblique 8.57 ±1.40 mins. All patients were successfully aligned on day one with no adverse events. Routine surgery on rectus and inferior oblique muscles were completed without surgical assistants and the instruments could fully expose the surgical field. Further validation studies are required with inclusion of superior oblique muscle surgery and complex cases.
Reporting the development and pilot use of fixable surgical instruments
Reviewed by Fiona Rowe
Novel fixable instruments used in strabismus surgery.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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