Topical Anesthesia in Children With Intraoperative Adjustable Strabismus Surgery

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Anesthesia

Background:

• Strabismus surgery in children often requires general anesthesia.
• Topical anesthesia offers potential benefits but requires careful patient selection and technique.
• Intraoperative suture adjustment allows for precise correction of eye alignment.

Purpose of the Study:

• To evaluate the safety and efficacy of strabismus surgery with intraoperative suture adjustment under topical anesthesia in pediatric patients.
• To assess patient tolerance and surgical outcomes in this cohort.

Main Methods:

• A prospective study involving 19 children with horizontal strabismus.
• A one-stage surgical technique using unilateral or bilateral muscle recession/resection under topical anesthesia.
• Intraoperative suture adjustment guided by the alternate prism cover test, with follow-up at 1 day and 1, 3, and 6 months.

Main Results:

• The mean age of patients was 12.68 years.
• Mean preoperative deviation was 24.21 PD, reduced to 4.11 PD at 6 months postoperatively.
• An 89% success rate (residual deviation ≤8 PD) was achieved, with 89% of patients tolerating the procedure well.

Conclusions:

• Strabismus surgery with intraoperative suture adjustment under topical anesthesia is a tolerable and effective procedure in well-selected children.
• This technique presents a viable alternative to general anesthesia.
• Thorough clinical evaluation is crucial to identify children who may not tolerate topical anesthesia, necessitating general anesthesia.