The Use of Conjunctival Anesthesia With Single-Stage Intra-Operative Adjustment for Complex Strabismus

Abstract

Purpose:: To determine the feasibility of conjunctival anesthesia and single-stage adjustment to treat strabismus associated with restriction and re-operations.

Methods:: We reviewed 2 years of strabismus surgery and compared success rates in adults with complex strabismus using conjunctival anesthesia and single-stage adjustment with success rates in non-complex and non-adjustable surgery. Strabismus surgery was defined as complex if the patient had prior eye muscle surgery or underlying restrictive disease. Surgical success was defined as a manifest horizontal strabismus of less than 10 prism diopters and vertical strabismus of less than 4 prism diopters at the final visit. Patients requiring re-operation were considered surgical failures. The degree of sensory fusion, diplopia, and use of prisms pre-operatively and post-operatively were also analyzed. Complications were recorded.

Results:: Success was 71% in 101 complex, adjustable cases; 64% in complex non-adjustable cases; and 78% in non-complex cases. There were no serious complications in the complex adjustable group.

Conclusions:: The use of conjunctival anesthesia with sedation is feasible for correcting complex strabismus.

Keywords: strabismus: treatment • strabismus • esotropia and exotropia