Reliability of the Mendonça Strabismus Forceps in Locating the Insertion of Extraocular Rectus Muscles in Patients Undergoing Strabismus Surgery

Abstract

Purpose: To evaluate the reliability of Mendonça strabismus forceps in locating the extraocular rectus muscles in patients undergoing primary strabismus surgery or reoperation. The study also compared the method's efficacy in primary surgeries versus reoperations. The overall goal was to avoid unnecessary surgical exploration, thereby enabling more effective planning and safer surgery. Methods: The study included 41 patients with strabismus undergoing surgical correction. The reliability of the Mendonça strabismus forceps in locating the extraocular rectus muscles was evaluated by comparing preoperative measurements using Mendonça strabismus forceps and Castroviejo forceps to intraoperative measurements made by direct muscle visualization. Differences of 1 mm or less were deemed acceptable. Results: In patients without prior surgery, Mendonça strabismus forceps reliably located all muscles, with measurements consistently within the 1-mm limit. All muscles with previous surgeries were successfully grasped by the forceps, except for one medial rectus muscle with multiple interventions. In reoperations with satisfactory muscle grasp, 88.8% showed coincident measurements. Non-coincidence cases were attributed to anomalous scarring. The method demonstrated simplicity, cost-effectiveness, and no complications in this study. Conclusions: The Mendonça strabismus forceps proved to be a reliable and non-invasive method for locating extraocular rectus muscles insertions without the need for additional imaging. It is a cost-effective, simple, and easily executed method that provides valuable information for surgical decision-making and planning. The method enhances surgical outcomes while reducing risks. [ J Pediatr Ophthalmol Strabismus . 20XX;X(X):XX–XX.]