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J. Tejedor, C. Ogallar; Dose and Pattern of Strabismus Surgery Under Topical Anesthesia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1137.
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© ARVO (1962-2015); The Authors (2016-present)
To compare surgical dose of strabismus surgery using topical anesthesia-adjusted dose in cooperative patients, with theoretical commonly used classic guidelines dosage.
Forty cooperative patients, requiring surgery for esotropia (n=20) or exotropia (n=20), were operated using topical anesthesia. Restrictive and paralytic strabismus cases were excluded. Visual acuity, refraction, binocular function (Bagolini lenses and synoptophore), and deviation angle (prism and cover test) were determined in all patients. The amount of surgery under topical anesthesia was adjusted intraoperatively. Linear regression models for topical and theoretical dosage were adjusted and compared. We also studied theoretical dosage versus difference between topical and theoretical dosage.
The amount of surgery required using topical anesthesia in patients with esotropia was 5.77 mm (95%CI: 5.26-6.28), i.e., 2.6 mm less on average (95%CI: 2.39-2.80) than indicated by theoretical guidelines. In exotropic patients, the total amount of surgery required using topical anesthesia was 10.52 mm (95%CI: 9.53-11.51), 0.92 mm less on average (95% CI: 0.13-1.71) than indicated in table guidelines. Intercept and slope values were significantly different between a dose/surgery linear regression model with topical anesthesia and a theoretical model, for patients with esotropia. Motor success rates with topical anesthesia were similar in esotropia and exotropia (17/20, 85%).
Topical anesthesia may be particularly advantageous in cooperative patients with esotropia, decreasing time and risk of additional surgery.
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