Objectives: Refractive changes have been studied after muscle surgery in literature but most results are inconsistent. It has been postulated that changes in corneal tension after muscle surgery may cause a change in corneal curvature resulting in the change in refraction postoperatively. This study investigated changes in corneal topography and clinical refraction after horizontal rectus muscle surgery. Methods: Twenty-one eyes of 13 patients underwent horizontal rectus muscle surgery via limbal approach. Manifest refraction, cycloplegic refraction, and corneal topography were measured preoperatively, and postoperatively at day 1 and weeks 1, 2, 4 and 8. The proportion of subjects with at least 0.5 D change from preoperative measurements and the proportion of subjects that needed new prescription postoperative were also computed. Analysis of the results were done using the Friedman test to identify significant differences among measurements at different time periods with post-hoc analysis utilized to identify specific time periods with significant changes from preoperative measurements. Results: Mean corneal keratometry, horizontal, vertical, and oblique astigmatism, obtained topographically showed no significant difference from preoperative measurements. The statistically significant difference in corneal astigmatism in the recession group at day 1, week 4 and week 8 postoperatively was not confirmed when converted to power vectors in both vertical/horizontal (J0) and oblique (J45) astigmatism. Clinical refraction showed a transient myopic shift in spherical equivalent, statistically significant only on postoperative day 1 in the recession group. There was no statistically significant difference in clinical astigmatism. There was ≥ 0.5 D change in spherical equivalent in 60% in both study groups by the end of follow-up. The shift in J0 was more than 10% in the recession group. More than fifty percent (52.4%) needed new prescription for glasses. Conclusion No statistically significant change in corneal topography and clinical refraction following horizontal rectus muscle surgery were found. Patients should still be refracted at least 2 weeks postoperatively to check if there is a need for change in prescription glasses to improve alignment and/or improve vision.
Astigmatism ; Oculomotor Muscles ; Ophthalmologic Surgical Procedures ; Vision Tests ; Strabismus

Objective: The purpose of this study was to describe the perceptions and satisfaction of the graduates and trainees of the fellowship programs of the Philippine General Hospital - Department of Ophthalmology and Visual Sciences (PGH DOVS). Methods: A uniform survey was conducted among all graduates and ongoing trainees of the External Disease and Cornea, Medical and Surgical Vitreo-Retina, Glaucoma, Orbit and Oculoplastics, and Pediatric Ophthalmology and Strabismus fellowship programs. The survey link was emailed to all the participants. Results: Response rate was 74%. Majority of graduates were clustered in the National Capital Region (NCR) (56.4%), and Luzon excluding NCR (46.4%). Majority of the graduates perceived that the objectives of their fellowship program were met (60%). Overall, 65.4% of the fellows assessed their training as completely adequate. Strengths identified were volume of patients, level of independence, and consultant supervision. Weaknesses identified were the lack of specialized instruments, lack of inter-department exposures, and difficulties in the conduct of research. Conclusion Majority were satisfied with their training and would recommend their training program to others despite the difficulties and deficiencies identified. Some of the perceived weaknesses observed by the graduates have been addressed since their graduation from their program. This is the first attempt to assess post-residency fellowship programs in ophthalmology in the Philippines.
fellowship ; training ; ophthalmology ; evaluation ; assessment