To Compare Horizontal Muscle Plication with Resection In Comitant Squint

Background and Aim: The procedure used commonly for correction of squint is divided into weakening and strengthening procedures. The standard weakening procedure done is recession. Present study aims to compare its efficacy with resection on horizontal rectus muscles and also see the long-term outcome of plication. Material and Methods: This was a randomized prospective interventional study at a tertiary health care centre, Central India. Eighty-Seven patients were included in the study. The comprehensive ocular examination consisted of visual acuity, anterior segment examination with slit lamp, detailed fundus evaluation along with Intraocular Pressure (IOP) measurements. Squint workup consisted of Hirschberg test, cover-uncover tests, Prism bar cover tests (PBCT). The PBCT with glasses is the final angle of deviation which is to be operated upon. Distance and near squint was measured by a prism and alternate cover testing at 6m and 1/3rd m respectively with best correction. Results: In esotropia the success rate for Lateral Rectus (LR) resection was 86.36%, with success rate for plication being comparable with 88.89%. While in the exotropia group, the success rate for MR resection was 90.00%, with a success rate for plication being 72.22%. Due to varied fundamental pathophysiological features, plication, and resection of MR have modestly less linear and less predictable effects in the treatment of exotropia. Preoperative angle of deviation with smaller deviations has better postoperative change. For Resection, all complications of plication were present also one case of slip muscle and a case of anterior segment ischemia was seen. Conclusion: As compared to the classical strengthening procedure Resection which is irreversible, Plication has many advantages like being less traumatic, lack of risk of lost muscle, Reversibility in the early postoperative period. A very major advantage being the potential less disruption of anterior ciliary vessels.