Single-stage adjustable strabismus surgery under topical anesthesia and propofol

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Strabismus surgery traditionally involves general or regional anesthesia.
• Adjustable strabismus surgery allows for intraoperative modifications to optimize alignment.
• Concerns exist regarding the risks associated with traditional anesthesia methods.

Purpose of the Study:

• To evaluate the feasibility and outcomes of single-stage adjustable strabismus surgery (SSASS) performed under topical anesthesia with propofol sedation.
• To assess patient comfort, safety, and efficacy of this anesthetic technique.

Main Methods:

• Sixteen patients at risk of or experiencing diplopia underwent SSASS.
• Procedures included lateral recti recession, medial recti adjustments, inferior oblique anteriorization, and superior rectus marginal myotomy.
• Patients received intravenous propofol for sedation followed by topical 2% lidocaine anesthesia, with adjustments made during the conscious phase.

Main Results:

• No patients reported significant intraoperative pain.
• No surgical complications were observed during or after the procedure.
• Postoperative follow-up confirmed the absence of diplopia in all patients.

Conclusions:

• Single-stage adjustable strabismus surgery under topical anesthesia and propofol sedation is a practical and safe alternative.
• Propofol provides effective sedation, pain prevention, and rapid recovery for intraoperative adjustments.
• This technique minimizes the risks associated with general and regional anesthesia in strabismus surgery.