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Ocular alignment under general anesthesia in congenital esotropia
A Castanera de Molina1, M L Giner Muñoz
1Instituto Castanera, Unidad de Oftalmologia Pediátrica y Estrabismo, Barcelona, Spain.
Journal of Pediatric Ophthalmology and Strabismus
|September 1, 1991
Summary
Ocular alignment in congenital esotropia patients differs significantly under general anesthesia compared to awake states. Current recommendations for intraoperative adjustments based on anesthetized alignment may increase surgical undercorrection rates.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Ocular alignment typically diverges under general anesthesia compared to the awake state in strabismus patients.
- Existing correlations (A = 0.8P + 30) may not accurately reflect anesthetized alignment, especially in esotropes versus exotropes.
Purpose of the Study:
- To investigate the response of ocular alignment to general anesthesia in congenital esotropia patients.
- To evaluate the reliability of anesthetized alignment for guiding intraoperative surgical adjustments in this population.
Main Methods:
- Analysis of ocular alignment data from 83 congenital esotropia patients under general anesthesia.
- Comparison of anesthetized alignment with preoperative deviation measurements.
Main Results:
- The average anesthetized alignment for the group was 6.2 prism diopters of esotropia, showing poor correlation with preoperative deviation.
- Mean anesthetized alignments were consistent across varying degrees of preoperative deviation.
Conclusions:
- Recommendations for intraoperative surgical adjustments based on anesthetized alignment in congenital esotropes require reconsideration and recalculation.
- Relying on current recommendations may lead to an increased rate of surgical undercorrection, potentially due to misclassification of cases using the Apt-Romano test.