Evidence map›Paper›PMID 34759666›Full record

ArticleMiddle East African journal of ophthalmology

Limbal Versus Fornix Incision for Strabismus Surgery: Preferences from a Consultant to a Trainee Level in Saudi Arabia.

Shatha Alfreihi, Hebatallah Ammar

Abstract read
In one paragraph

Article in Middle East African journal of ophthalmology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Investigation of the effects of single and two-muscle horizontal rectus surgeries on macular microvasculature.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Shatha AlfreihiDepartment of Pediatric Surgery, Division of Pediatric Ophthalmology, King Abdullah Specialist Children's Hospital, National Guards, Riyadh, Saudi Arabia.
Hebatallah AmmarKing Abdullah International Medical Research Center, National Guards, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to identify the use of limbal versus fornix incisions among strabismus surgeons in Saudi Arabia and the preferred approach to teaching trainees with the shortest learning curve.

methodsTwo designed questionnaires were sent to local strabismus surgeons and ophthalmology trainees.

resultsA total of 127 participants responded to our survey: fifty-nine consultants (53% Saudi nationals and 43% expat ophthalmologists) and 68 trainees. The limbal approach was the preferred approach for all settings, including the primary pediatric procedure (30, 55.9%), pediatric reoperation (40, 64.7%), adult primary procedure (32, 55.9%), and reoperation (40, 70%). The reason was attributed to better exposure. As for fornix incision, the most commonly cited reason was less pain and discomfort. For the adjustable suture technique, 29 (49.2%) did not use adjustable sutures, and 22 (37.3%) prefer the limbal approach. When we compared Saudi versus non-Saudi surgeons, 26 (83.87%) Saudi surgeons were trained to perform the limbal method, whereas 16 (57.14%) non-Saudi surgeons were trained to perform the fornix approach. Of the trainees, 35 (51%) were trained on the limbal approach. When asked about the learning curve for different methods, 41 (60.3%) noted a faster learning curve with the limbal approach.

conclusionDespite the many advantages of the fornix incision, it remains uncommon in our region. Each technique of strabismus surgery has its advantages and disadvantages. Programs should teach all methods to trainees. One should add all styles to his armamentarium and choose the appropriate one for each patient.

Indexed as

OphthalmologyStrabismusAdultChildConsultantsHumansOculomotor MusclesSaudi ArabiaFornix incisionlimbal incisionstrabismus surgeryteaching residents

Identifiers

PMID34759666
PMCPMC8547663

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.