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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Evaluation of the insertion distance of the medial rectus in consecutive exotrop...
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Vol. 96. Issue 10.
Pages 521-526 (October 2021)
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Vol. 96. Issue 10.
Pages 521-526 (October 2021)
Original article
Evaluation of the insertion distance of the medial rectus in consecutive exotropia by means of intraoperative measure and optical coherence tomography
Evaluación de la distancia al recto medio en la exotropía consecutiva mediante tomografía de coherencia óptica y medida intraoperatoria
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L. de-Pablo-Gómez-de-Liañoa,
Corresponding author
depablo.lucia@gmail.com

Corresponding author.
, J.A. Reche-Sainza, J.I. Fernández-Vigob, M. Ferro-Osunaa
a Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Oftalmología, Hospital Universitario Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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Table 1. Baseline characteristics and measurements of patients with consecutive exotropia whose limbal distance was assessed by optical coherence tomography and measured intraoperatively.
Abstract
Purpose

To assess the agreement between the measurements of the distance from the medial rectus muscles insertion to the limbus measured by intra-operative spectral-domain optical coherence tomography (SD-OCT) in consecutive exotropia (cXT).

Methods

An analysis was performed on total of 14 medial rectus (MR) muscles of 14 patients who underwent surgery for the treatment of cXT. The limbus-insertion distance of the MR muscles was measured using preoperative SD-OCT and intraoperatively using a calliper. The intraclass correlation coefficient (ICC) and Bland Altman plots were calculated to determine the agreement between the two methods, as well as the correlation.

Results

Mean age was 36.3 ± 16.0 years (range 13–60), with 60% being women. Mean preoperative deviation was 38.7 ± 16.9 prismatic dioptres (PD) (range 16–65), being +1.3 ± 6.3 PD (range −12 to +10 PD) after surgery. Intraoperatively the MR insertion was found at 8.7 ± 2.1 mm (range 5.5–12.0) and by OCT at 7.7 ± 1.2 mm (range 5.3–10.0). The ICC showed a moderate to good agreement (0.659; 95% confidence interval: 0.157−0.885; p < 0.001), with a correlation of R = 0.792 (p = 0.011). A better agreement was observed in those MR that were less retro-inserted.

Conclusions

SD-OCT is able to measure the insertion to the limbus distance of the medial rectus muscles that have been previously operated on, showing moderate to good agreement with intraoperative measurements. However, the agreement was poor in muscles with a large retro-insertion.

Keywords:
Optical coherence tomography
Extraocular muscles
Consecutive exotropia
Medial rectus insertion
Limbus-insertion distance
Resumen
Propósito

Valorar la concordancia de la medición intraoperatoria de la distancia de la inserción del recto medio (RM) al limbo corneal con la obtenida preoperatoriamente mediante tomografía de coherencia óptica de dominio espectral (SD-OCT) en pacientes con exotropia consecutiva (XTc).

Métodos

Se analizaron 14 RM de 14 pacientes con XTc posquirúrgica que iban a ser reintervenidos. La distancia inserción-limbo fue medida preoperatoriamente mediante SD-OCT y de forma intraoperatoria con compás. Se calculó el coeficiente de correlación intraclase (CCI) y un análisis de Bland Altman para analizar la concordancia de las medidas, estudiándose además la correlación de las mismas.

Resultados

La edad media fue 36,3 ± 16,0 años (rango 13–60), siendo el 57% mujeres. La desviación ocular media preoperatoria de la XT fue 38,7 ± 16,9 dioptrías prismáticas (DP) (rango 16 a 65), siendo el resultado tras la cirugía de +1,3 ± 6,3 DP (rango −12 a +10 DP). Intraoperatoriamente se halló la inserción del RM a 8,7 ± 2,1 mm (rango 5,5–12,0) y con OCT a 7,7 ± 1,2 mm (rango 5,3–10,0). El CCI mostró una concordancia moderada-buena (0,659; intervalo de confianza al 95%: 0,157–0,885; p < 0,001), hallándose una correlación de R = 0,792 (p = 0,011). Se observó una mayor concordancia en aquellos RM que se hallaban menos retroinsertados.

Conclusiones

La SD-OCT puede ser una técnica útil para valorar la distancia de la inserción al limbo corneal de los RM previamente retroinsertados, hallándose una concordancia moderada-buena con la medida intraoperatoria. Sin embargo, la concordancia fue baja en músculos muy retroinsertados.

Palabras clave:
Tomografía de coherencia óptica
Músculos extraoculares
Exotropia consecutiva
Inserción recto medio
Distancia inserción-limbo

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