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Purpose <p>To characterize short-term dynamic changes in iris microcirculation after horizontal strabismus surgery and to explore their associations with postoperative binocular visual function.</p> Methods <p>In this prospective self-controlled study, 71 eyes from 56 patients who underwent horizontal rectus muscle surgery at Shanxi Provincial Eye Hospital between June and October 2025 were enrolled (one-muscle group: 17 eyes; two-muscle group: 54 eyes). Anterior segment OCT angiography was performed 1&#xa0;day before surgery and at 1&#xa0;day, 2 weeks, and 6 weeks postoperatively to quantify iris vessel density (VD), iris vessel skeleton density (VSD), and iris perfusion area (PA). Synoptophore testing was used to assess simultaneous perception/fusion grades, and near stereopsis was assessed with the Titmus test. Linear mixed-effects models were applied to examine associations between functional variables and OCTA metrics.</p> Results <p>Iris VD and VSD exhibited reversible short-term fluctuations after surgery, with larger changes in the two-muscle group, whereas PA remained relatively stable. From postoperative week 2 onward, simultaneous perception, fusion, and stereopsis generally improved. Mixed-effects modeling indicated negative associations of the number of operated muscles with VD and VSD, and positive associations of simultaneous perception/fusion with VSD. No significant correlation was found between Titmus stereopsis and OCTA parameters.</p> Conclusions <p>Horizontal strabismus surgery is associated with subclinical, reversible short-term alterations in iris microcirculation. The association between iris OCTA parameters, particularly VSD, and synoptophore grade I/II function suggests that these metrics may provide complementary information during postoperative functional assessment; however, binocular recovery remains influenced by ocular alignment and other sensory factors.</p>

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Changes in iris microvasculature after horizontal strabismus surgery: anterior segment OCTA combined with synoptophore-based functional assessment

  • 期刊论文

  • 发表日期：

    2026年7月14日

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  • Wenwen Guo,
  • Junhong Li

摘要

Purpose

To characterize short-term dynamic changes in iris microcirculation after horizontal strabismus surgery and to explore their associations with postoperative binocular visual function.

Methods

In this prospective self-controlled study, 71 eyes from 56 patients who underwent horizontal rectus muscle surgery at Shanxi Provincial Eye Hospital between June and October 2025 were enrolled (one-muscle group: 17 eyes; two-muscle group: 54 eyes). Anterior segment OCT angiography was performed 1 day before surgery and at 1 day, 2 weeks, and 6 weeks postoperatively to quantify iris vessel density (VD), iris vessel skeleton density (VSD), and iris perfusion area (PA). Synoptophore testing was used to assess simultaneous perception/fusion grades, and near stereopsis was assessed with the Titmus test. Linear mixed-effects models were applied to examine associations between functional variables and OCTA metrics.

Results

Iris VD and VSD exhibited reversible short-term fluctuations after surgery, with larger changes in the two-muscle group, whereas PA remained relatively stable. From postoperative week 2 onward, simultaneous perception, fusion, and stereopsis generally improved. Mixed-effects modeling indicated negative associations of the number of operated muscles with VD and VSD, and positive associations of simultaneous perception/fusion with VSD. No significant correlation was found between Titmus stereopsis and OCTA parameters.

Conclusions

Horizontal strabismus surgery is associated with subclinical, reversible short-term alterations in iris microcirculation. The association between iris OCTA parameters, particularly VSD, and synoptophore grade I/II function suggests that these metrics may provide complementary information during postoperative functional assessment; however, binocular recovery remains influenced by ocular alignment and other sensory factors.