e20 Volume 16 Number 1 / February 2012

significant overcorrection. Moreover it is a simple, less time consum-ing procedure with no risk of scleral perforation. Since the successrate is the same in both the groups hang back recessions is definitelya better option.Conclusions: The hang-back recession technique represents a safeand effective alternative to conventional recessions in horizontalcommitant strabismus.

073 The effect of commonly used surgical solutions on the tensilestrength of Vicryl sutures. Saurabh Jain, Radhika Gulati, RichardGoodeyPurpose:With an increasing awareness of endophthalmitis followingsquint surgery, and the discovery of bacterial load in unused vicrylsutures,a new practice of soaking sutures in antibiotics and/or beta-dine solutions prior to use has developed. Our aim is to study the ef-fect of solutions used commonly in strabismus surgery on6-0 Vicryl suture tensile strength.Methods: The testing regime comprised a dead load test, whereby 10specimens of 6/0 Vicryl suture were loaded in simple tension untilfailure occurred, to calculate the breaking force in Newtons (N).Without modification (A), after soaking in solution for 30 minutes-normal saline (B), 5% betadine solution (C), 0.5% chloramphenicolsolution (D).Results: The mean breaking force across all groups was 4.24 N witha standard deviation (SD) of 0.27. The mean force and SD across thefour groups was (A 5 4.24, 0.39; B 5 4.28, 0.29; C 5 4.20, 0.23;D 5 4.26, 0.17). There was no significant difference between thefour groups (P 5 0.945, ANOVA). We also compared each of thethree suture types with the untreated suture with no significantdifference.Discussion: There is no change in tensile strength of 6-0 Vicryl sutureafter immersion in the various solutions for 30 minutes. To further re-fine these results, a creep test needs to be conducted to ensure thatthere is no significant effect on the sutures between insertion andabsorption.Conclusion: Soaking Vicryl sutures in various solutions used in stra-bismus surgery for 30 minutes had no effect on tensile strength.

074 The psychological status of adults with strabismus seekingsurgery. Hayley James, Charis Au, Kelly MacKenzie, Jo Hancox,Daniel, Gillian Adams, Stanton NewmanBackground/Purpose: Strabismus can have a considerable impacton a patient's quality of life (QoL). Patients seek surgery to treat dou-ble vision or for improved ocular alignment. This study aims to iden-tify the clinical and psychological factors that are associated withQoL in adults with strabismus undergoing surgery.Methods: A prospective cross-sectional study was conductedrecruiting consecutive patients listed for strabismus surgery. 48patients completed a number of psychological questionnaires andunderwent standard assessments of ocular deviation and visualfunction. QoL was measured using the Adult Strabismus Quality ofLife Questionnaire (AS-20).Results: The sample was 48% female with a mean age of 45 years.Mean scores on the AS-20 were 61.15 (SD5 21.11), over 80% of par-ticipants scored below norms. A forward stepwise multiple regres-sion suggests that a combination of 5 psychosocial variablesexplained 77.6% of the variance in overall QoL. No significant rela-tionships between found between clinical variables and overall QoL.Discussion: Mean AS-20 scores indicate poor QoL and this was as-sociated with psychosocial rather than clinical variables. Poorer QoLwas associated with having strong beliefs about the negative conse-

quences of your strabismus, a more negative self-evaluation of yourappearance, having strong functional and psychological motivationsfor surgery and higher expectations of postoperative improvementsin social relationships.Conclusions: There is a definite need to identify those patients withpoor QoL prior to surgery. Successful adjustment to strabismus ap-pears to be associated with psychological rather than clinical fac-tors. These factors may be targeted to develop appropriatepsychological interventions before surgery.

075 Detecting amblyopia and strabismus in children with thePediatric Vision Scanner (PVS). Jessica Kane, Sina Salehi Omran,Sean P. DonahuePurpose:Most photoscreening technology identifies patients havingamblyopia risk factors; however, not all patients with risk factors de-velop amblyopia or strabismus. PVS identifies lack of central fovealfixation as a direct indicator of amblyopia or strabismus. We soughtto validate this technology.Methods: A prospective study identified and screened 77 clinic pa-tients between ages three and eight. All patients had complete eyeexams with cycloplegic retinoscopy and were classified as at riskfor amblyopia if any of the AAPOS VSC amblyopia risk factorswere present. Strabismus was further defined as constant or inter-mittent. All patients were screened using PVS, and the device'spass/refer recommendation was used to calculate sensitivity andspecificity.Results: Of the 77 patients, 16 were normal (no amblyopia riskfactors) and 61 were amblyopic or had risk factors. 14 had anisome-tropic amblyopia; 21 had constant strabismus (11 amblyopic); 17 hadintermittent strabismus (11 amblyopic, typically partially or fullyaccommodative esotropia with monofixation syndrome or post-op-erative from strabismus surgery); and 9 had nonstrabismus nonani-sometropic risk factors for amblyopia (1 amblyopic). Sensitivity toamblyopia was 95% (35/37, including one referral misidentifyingthe amblyopic eye). Sensitivity to constant strabismus withoutamblyopia was 60%. Sensitivity to intermittent strabismus withoutamblyopia was 50%. With respect to AAPOS amblyopia risk factors,overall sensitivity was 84% (51/61) and specificity was 75% (12/16).Discussion: PVS is very effective at detecting amblyopia and issensitive to amblyopia risk factors in children who do not presentwith amblyopia.Conclusions: PVS shows potential to screen children aged 3-8 forpresent amblyopia and strabismus.

076 Digital imaging identification of skip lesions in lasertreatment of retinopathy of prematurity. Kai B. Kang, Anton Orlin,Thomas C. Lee, Michael F. Chiang, R. V. Paul ChanPurpose: To identify common locations of skip lesions in laser-treatedROP eyes and to evaluate the utility of wide-angle digital imaging indetecting and documenting skip lesions.Methods: Retrospective review of digital retinal images of 22 eyes of13 infants who had undergone laser treatment performed by ophthal-mologists within two years of completing residency. Presence of skiplesions was determined by masked review of photographs. The loca-tion of skip lesions was classified based on two axes: (1) circumfer-ential (in one of six clock-hour regions), and (2) radial (adjacent tointraretinal ridge, adjacent to ora serrata, or isolated patches ofgreater than 1 laser burn width). Data was analyzed using Pearson'sc2 test.Results: Based on circumferential location, a significant difference inlesion distribution was found (P 5 0.016). Regions with the highest

Journal of AAPOS