Complications of Eye Muscle Surgery

Abstract

Although it is normal to have some degree of pain and irritation after strabismus surgery, one must always be attentive to the remote possibility of a cellulitis , which requires systemic antibiotics, or the even more remote possibility of endophthalmitis. Usually, swelling and discomfort are most prominent the morning after surgery and improve as the day progresses. However, if the symptoms are worsening, and particularly if the pain is of a deep nature, as opposed to surface irritation, the patient should be seen to rule out a serious problem. Common causes of surface pain include suture irritation (if conjunctival sutures were used), deleon formation, or filamentary keratitis. For reasons that are not clear, preseptal cellulitis can occur and is more common than orbital cellulitis after strabismus surgery. One also must consider an allergic conjunctivitis to be the cause if postoperative topical antibiotics were used. If bilateral surgery was performed, and the irritation is unilateral, you are not dealing with an allergic problem. Treatment of allergic conjunctivitis includes discontinuing the offending medication, and if severe a short course of mild topical steroids.

I know a surgeon who always says a prayer at the start of each case,

“God, these are your hands. Don’t embarrass yourself.”

—Thich Nhat Hahn