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Vagal responses to adjustable sutures in strabismus correction
H S Eustis1, C C Eiswirth, D R Smith
1Department of Ophthalmology, Ochsner Clinic, New Orleans, LA 70121.
American Journal of Ophthalmology
|September 15, 1992
Summary
The oculocardiac reflex, a complication of eye surgery, commonly occurs during strabismus suture adjustments. Monitoring revealed a significant incidence of vagal responses, primarily a decreased heart rate, in patients undergoing this procedure.
Area of Science:
- Ophthalmology
- Cardiology
- Surgical Complications
Background:
- The oculocardiac reflex is a known risk associated with ocular stimulation, often triggered by extraocular muscle manipulation.
- Its precise incidence during specific surgical interventions like strabismus suture adjustment requires further investigation.
Purpose of the Study:
- To ascertain the actual incidence of the oculocardiac reflex during strabismus suture adjustments.
- To identify the most frequent physiological responses and symptoms associated with this reflex during the procedure.
Main Methods:
- Twenty patients undergoing strabismus suture adjustment were monitored for hemodynamic changes (blood pressure, heart rate, rhythm).
- A control group of ten postoperative strabismus patients was observed for comparison.
- Statistical analysis (P < .001) was used to compare the incidence of vagal responses between groups.
Main Results:
- A significant number of patients (13) in the study group exhibited a vagal response compared to controls (2).
- The most common manifestation was a heart rate decrease, observed in 15 patients.
- Only two patients reported symptoms: lightheadedness and nausea/vomiting.
Conclusions:
- Strabismus suture adjustment is a frequent trigger for oculocardiac reflex-induced vagal responses.
- Surgeons must be aware of this reflex to counsel patients and implement preventive measures.
- The reflex is often asymptomatic, but awareness is crucial for patient safety.