Influence of light optomotor reflex on intraoperative adjustment of eye muscle surgery

The eyes diverge under general anesthesia. The amount of divergence is predictable: there is a linear relationship between the preoperative and the anesthetized eye position. We recently reported that adjusting the amount of surgery to be done in cases deviating from this correlation significantly improved surgical results. The light optomotor reflex had not, however, been considered in making these measurements. We modified our procedure to eliminate this reflex in our next 100 patients. The measurements were not significantly different from prior studies. We confirmed the prior regression formula of Apt and Isenberg (A = 0.8P + 30) and our previously reported improvement in surgical success rate (from 47% to 88%) following intraoperative adjustment of the amount of surgery to be performed.