Squint operation under topical anesthesia in endocrine orbitopathy A 15 years' experience

In the past 15 years all of our strabismus procedures in patients suffering from endocrine orbitopathy were carried out under topical anesthesia with full retention of all active motility of the globe. A total of 74 patients were operated on under such conditions with a total of 111 ocular muscles. In all instances the most affected muscle was the first to be operated on. In 52% of the patients this involved the inferior rectus muscle. Forty-five of the described patients required one operation, 21 needed two ocular muscle operations and four of the described patients needed a surgical procedure three times. In 91 % of the cases the ocular muscle surgery alone or the post-operative addition of prismatic correction led to a useful field of binocular single vision and stereopsis. A clear amount-to-effect correlation resulting from such surgery could not be established. The mechanical nature of the motility disturbance in these patients did not allow such a conclusion.