Abstract

Aim-To report case of ASI in early post-operative period despite vessel sparing squint surgery
Method-A 59 years old female patient diagnosed with left eye (LE) lateral rectus (LR) paresis underwent LE medial rectus (MR) recession by Modified Kozeis technique with full tendon transposition of superior and inferior rectus to LR with Foster augmentation. Anterior ciliary arteries of the MR muscle were preserved successfully. On post-operative day (POD) 1, she was orthotropic with mild anisocoria and normal anterior segment. POD 8, she had mild anisocoria with corneal edema and AC reaction. OCT-A of iris vasculature showed filling defects in inferior and superior quadrants. She was treated with topical, oral steroids and cycloplegic eye-drops and she improved within a week which was also evident on OCT-A.
Conclusion-Risk factors for ASI are age, number of muscles especially vertical muscle involvement, blood dyscrasias.