Article Text

Original research
Extraocular muscle resection, recession length and surgery outcome modelling in strabismus treatment: a pilot study
  1. Ala Paduca1,2,
  2. Oleg Arnaut3,
  3. Eugeniu Bendelic2,
  4. Jan Richard Bruenech1,
  5. Per Olof Lundmark1
  1. 1Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
  2. 2Ophthalmology Department, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
  3. 3Department of Human Physiology and Biophysics, Nicolae Testemitanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova
  1. Correspondence to Dr Ala Paduca; paducaa{at}


Background Many surgical formulas have been developed and proposed based on the experience of surgeons to improve the predictability of strabismus surgery. However, the consent among strabismus surgeons regarding the dose effect of the extraocular muscle (EOM) recession or resection was not achieved yet and the disagreement about the appropriate amount of strabismus surgery still exists.

Objective Our study aimed to propose an instrument for EOM resection (RsL) and recession length (RcL) estimation before the surgery and second to elaborate an postoperative angle of deviation (PAD) predictive model using simple potential predictors.

Methods and Analysis The analytical prospective clinical study was conducted from April 2016 to July 2019, on a sample of 216 patients (aged between 2–58) with concomitant strabismus who underwent strabismus surgery in Clinical Republican Hospital ‘Timofei Mosneaga’and Children Hospital ‘Em Cotaga’ from Republic of Moldova. The correlations of patients’ age, strabismus type, amblyopia degree, RsL, RcL, preoperative angle of deviation (PreAD) with PAD were estimated using Pearson’s correlation analysis. Multiple linear regression analysis, multicollinearity analysis and residual analysis were performed.

Results The EOM RsL was predicted using strabismus type, patient’s age, PreAD and EOM RcL. EOM RcL, in turn, was estimated by the similar covariates set, instead of RcL being RsL. PAD modelling showed the PreAD, EOM RsL and EOM RcL predictive ability for strabismus surgery outcome prediction.

Conclusion In our study, we propose four mathematical models as potential instruments for EOM RsL, EOM RcL and PAD modelling in esotropia and exotropia surgery.

  • treatment surgery
  • muscles

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors AP and OA were involved in the design of the study; AP collected the data and is resposible for the overall content of the atricle; AP and OA analysed the data and wrote the manuscript; and EB, JRB and POL revised the manuscript. All authors read and approved the final manuscript. AP is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.