METHODS: A prospective study was conducted in patients with strabismus who had been treated with surgery in the First Affiliated Hospital of Nanyang Medical College between January 2017 and October 2019. The subjects were divided into conjunctival flap incision group(60 cases with 82 affected eyes treated with strabismus surgery via corneal limbal trapezoid conjunctival flap incision)and modified Parks group(62 cases with 83 affected eyes treated with strabismus surgery via modified Parks incision). Therapeutic effects on strabismus were evaluated, and dry eye symptoms were scored before and after surgery. Schirmer I test(SⅠt), tear film break up time(BUT)and cornea fluorescein staining score(FL score)were recorded. Comprehensive ocular surface examination was performed to determine tear river height(TMH)and noninvasive keratograph tear breakup time(NIKBUT). Satisfaction with surgery was surveyed, and adverse reactions were statistically analyzed.

RESULTS: Both groups of patients completed the surgery. Totally 80 eyes and 79 eyes of the conjunctival flap incision group and the modified Parks group were basically in normal position(within±10PD), and there was no statistically significant difference in cure rate between the two groups(P>0.05). S I t and BUT of the modified Parks group were significantly higher than those of the conjunctival flap incision group at 7 and 14d after surgery, and the FL score was significantly lower than that of the conjunctival flap incision group at 7d after surgery(P<0.05). TMH of the modified Parks group was significantly higher than that of the conjunctival flap incision group at 14d after surgery, and NIKBUT was significantly longer than that of the conjunctival flap incision group at 7d and 14d after surgery(P<0.05). The overall incidence rates of complications in the conjunctival flap incision group and the modified Parks group were 7.3% and 2.4%, respectively(P>0.05). The overall satisfaction rates of the conjunctival flap incision group and the modified Parks group were 83.3% and 95.2%, respectively(P<0.05).

CONCLUSION:Surgeries with corneal limbal trapezoid conjunctival flap incision or modified Parks incision can achieve good correction effects on strabismus, but surgery with modified Parks incision has less effect on tear film stability, with higher surgical satisfaction and better clinical application effect.