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Laser speckle contrast imaging enables perfusion monitoring of the anterior segment during strabismus surgery: a study on the horizontal rectus muscles

Engqvist, Linn LU ; Sheikh, Rafi LU orcid ; Albinsson, John LU ; Blohmé, Jonas LU ; Lindstedt, Sandra LU and Dahlstrand, Ulf LU (2023) In British Journal of Ophthalmology 107. p.1704-1708
Abstract
Background A dreaded complication of strabismus surgery is anterior segment ischaemia (ASI), caused by damage to the anterior ciliary arteries. To avoid ASI, a maximum of two rectus muscles are operated on at a time. However, these surgical protocols are based on empirical observations of clinical outcome, rather than objective perfusion measurements. There is no method available for perioperative, real-time perfusion measurements during ocular muscle surgery. The aims of this study were to investigate whether laser speckle contrast imaging (LSCI) could be used for such measurements, and to monitor perfusion during strabismus surgery on one or two horizontal rectus muscles.Methods Forty-four eyes in 44 patients with horizontal strabismus... (More)
Background A dreaded complication of strabismus surgery is anterior segment ischaemia (ASI), caused by damage to the anterior ciliary arteries. To avoid ASI, a maximum of two rectus muscles are operated on at a time. However, these surgical protocols are based on empirical observations of clinical outcome, rather than objective perfusion measurements. There is no method available for perioperative, real-time perfusion measurements during ocular muscle surgery. The aims of this study were to investigate whether laser speckle contrast imaging (LSCI) could be used for such measurements, and to monitor perfusion during strabismus surgery on one or two horizontal rectus muscles.Methods Forty-four eyes in 44 patients with horizontal strabismus underwent corrective surgery involving medial and/or lateral rectus muscle detachment. Perfusion in the adjacent paralimbal and iris tissue was monitored with LSCI.Results When the first horizontal rectus muscle was detached perfusion in the adjacent paralimbal tissue decreased by 23% (p<0.0001), and by 12% (p<0.0001) when the second muscle was detached. The iris perfusion decreased by 5% (p<0.05) when the first muscle was detached but showed no significant decrease as the second muscle was cut.Conclusion This is the first study showing that perfusion of the anterior segment can be monitored non-invasively with LSCI during strabismus surgery. In this cohort, two horizontal rectus muscles were detached with only a small decrease in the anterior segment circulation. Future studies are required for complete mapping of the effect of surgery on multiple ocular muscles on the anterior segment circulation.Data are available upon request. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Ophthalmology
volume
107
pages
1704 - 1708
publisher
BMJ Publishing Group
external identifiers
  • scopus:85137829192
  • pmid:36126106
ISSN
1468-2079
DOI
10.1136/bjo-2022-321214
language
English
LU publication?
yes
id
661b1322-0dee-4b3c-abf6-fc5fe49e262c
date added to LUP
2022-09-13 01:01:30
date last changed
2024-01-08 11:14:20
@article{661b1322-0dee-4b3c-abf6-fc5fe49e262c,
  abstract     = {{Background A dreaded complication of strabismus surgery is anterior segment ischaemia (ASI), caused by damage to the anterior ciliary arteries. To avoid ASI, a maximum of two rectus muscles are operated on at a time. However, these surgical protocols are based on empirical observations of clinical outcome, rather than objective perfusion measurements. There is no method available for perioperative, real-time perfusion measurements during ocular muscle surgery. The aims of this study were to investigate whether laser speckle contrast imaging (LSCI) could be used for such measurements, and to monitor perfusion during strabismus surgery on one or two horizontal rectus muscles.Methods Forty-four eyes in 44 patients with horizontal strabismus underwent corrective surgery involving medial and/or lateral rectus muscle detachment. Perfusion in the adjacent paralimbal and iris tissue was monitored with LSCI.Results When the first horizontal rectus muscle was detached perfusion in the adjacent paralimbal tissue decreased by 23% (p<0.0001), and by 12% (p<0.0001) when the second muscle was detached. The iris perfusion decreased by 5% (p<0.05) when the first muscle was detached but showed no significant decrease as the second muscle was cut.Conclusion This is the first study showing that perfusion of the anterior segment can be monitored non-invasively with LSCI during strabismus surgery. In this cohort, two horizontal rectus muscles were detached with only a small decrease in the anterior segment circulation. Future studies are required for complete mapping of the effect of surgery on multiple ocular muscles on the anterior segment circulation.Data are available upon request.}},
  author       = {{Engqvist, Linn and Sheikh, Rafi and Albinsson, John and Blohmé, Jonas and Lindstedt, Sandra and Dahlstrand, Ulf}},
  issn         = {{1468-2079}},
  language     = {{eng}},
  pages        = {{1704--1708}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{British Journal of Ophthalmology}},
  title        = {{Laser speckle contrast imaging enables perfusion monitoring of the anterior segment during strabismus surgery: a study on the horizontal rectus muscles}},
  url          = {{http://dx.doi.org/10.1136/bjo-2022-321214}},
  doi          = {{10.1136/bjo-2022-321214}},
  volume       = {{107}},
  year         = {{2023}},
}