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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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ORIGINAL ARTICLE
Year : 2021  |  Volume : 28  |  Issue : 2  |  Page : 93-97

Limbal versus fornix incision for strabismus surgery: Preferences from a consultant to a trainee level in Saudi Arabia


1 Department of Pediatric Surgery, Division of Pediatric Ophthalmology, King Abdullah Specialist Children's Hospital, National Guards, Riyadh; King Abdullah International Medical Research Center, National Guards, Riyadh; King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) Saudi Arabia, Abha, Saudi Arabia
2 King Abdullah International Medical Research Center, National Guards, Riyadh; Department of Surgery, Division of Ophthalmology, Asir Central Hospitwal, Abha, Saudi Arabia

Correspondence Address:
Dr. Shatha Alfreihi
Department of Pediatric Surgery, Division of Pediatric Ophthalmology, King Abdullah Specialized Children's Hospital, Ministry of National Guards Health Affairs, Central Region, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/meajo.meajo_103_21

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PURPOSE: This study aims to identify the use of limbal versus fornix incisions among strabismus surgeons in Saudi Arabia and the preferred approach to teaching trainees with the shortest learning curve. METHODS: Two designed questionnaires were sent to local strabismus surgeons and ophthalmology trainees. RESULTS: A total of 127 participants responded to our survey: fifty-nine consultants (53% Saudi nationals and 43% expat ophthalmologists) and 68 trainees. The limbal approach was the preferred approach for all settings, including the primary pediatric procedure (30, 55.9%), pediatric reoperation (40, 64.7%), adult primary procedure (32, 55.9%), and reoperation (40, 70%). The reason was attributed to better exposure. As for fornix incision, the most commonly cited reason was less pain and discomfort. For the adjustable suture technique, 29 (49.2%) did not use adjustable sutures, and 22 (37.3%) prefer the limbal approach. When we compared Saudi versus non-Saudi surgeons, 26 (83.87%) Saudi surgeons were trained to perform the limbal method, whereas 16 (57.14%) non-Saudi surgeons were trained to perform the fornix approach. Of the trainees, 35 (51%) were trained on the limbal approach. When asked about the learning curve for different methods, 41 (60.3%) noted a faster learning curve with the limbal approach. CONCLUSION: Despite the many advantages of the fornix incision, it remains uncommon in our region. Each technique of strabismus surgery has its advantages and disadvantages. Programs should teach all methods to trainees. One should add all styles to his armamentarium and choose the appropriate one for each patient.


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