Surgical Results of Intraoperative Adjustable Suture Strabismus Surgery under Local Anesthesia

ABSTRACT

PURPOSE: We assessed the postoperative surgical results of intraoperative adjustment technique under topical and subconjunctival anesthesia in children and adult strabismus patients. METHODS: 48 patients (55 cases) who underwent intraoperative adjustable strabismus surgery under topical and subconjunctival local anesthesia in Pusan National University Hospital between the years 2001 and 2004 were examined retrospectively. The deviations preoperatively, at postop. 1 day, 1 month, 3 months and last follow up were measured and follow up period ranged from 3 months to 39 months, average 7.5 months. Success was defined as alignment of overcorrection within 5delta and undercorrection within 10delta at horizontal strabismus, and as alignment within 5delta at vertical strabismus. RESULTS: Of the 48 patients identified (20 men and 28 women; mean age 29.6 years), 28 had exotropia, 9 had esotropia, 4 had vertical strabismus, and 7 had both horizontal and vertical strabismus. The success rates for exotropia were 84.8% at postop. 3 months and 81.8% at last follow up and 81.8% for esotropia respectively and 72.7% for vertical strabismus respectively. Mean change in the angle of deviation between postoperative 1 day and last follow up was 5.3delta for cases of exotropia, 2.4delta for esotropia and 1.8delta for hypertropia. The visual acuity, preoperative deviation, amount of adjustment, number of operated muscles, and monocular or binocular strabismus surgery had no statistically significant influence on the surgical outcome and change of deviation. CONCLUSIONS: Intraoperative adjustable suture strabismus surgery under topical and subconjunctival local anesthesia had relatively successful results. Postoperative drift toward the original deviation was observed.