Topical Anesthesia in Pediatric Strabismus Surgery

Kim, Seong Ju; Park, Yeoung Geol

Abstract

Children with mature visual functions can suffer from diplopia when overcorrection after strabismus surgery occurred. If the patients are willing to undergo the adjustment procedure under a topical anesthesia, we feel that it is also possible to perform the strabismus surgery in the same manner. We operated 58 strabismic children (male 37, female 21) aging from 6 to 14 under topical anesthesia using only 0.5% proparacaine (Alcaine). After bow tie suture around end of the surgery, patients were assisted in sitting upright on the operating table, asked to fixate on a 20/40 accomodative target. Subsequently, we adjusted ocular alignment to nearly orthophoria. The overall success rate was 67.2% (39/58) ; horizontal strabismus with fusion potential (74.4%) was more successful than horizontal and/or vertical combined strabismus without fusion potential (52.6%) and one muscle surgery in horizontal strabismus regardless of fusion potential (36.4%). In conclusion, this study revealed that strabismus surgery under topical anesthesia had many advantages including day surgery, decreased complications and decreased the number of surgery.