Stepped Strabismus Surgery

CLINICAL OPHTHALMOLOGY(2021)

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摘要
Purpose: To present stepped strabismus surgery as a novel technique in cases of small to moderate angle strabismus. Methods: Retrospective chart review of cases of stepped strabismus surgery from 2010 untill 2018. In stepped surgery, the first muscle is operated on under rapid induction-recovery IV propofol infusion. Patient is assessed in the OR. If deemed necessary, other muscles are operated on under general anesthesia. No adjustable sutures are used. Results: The technique was used in 22 cases of superior oblique palsy (SOP) (primary position hypertropia in the range of 12-25 prism diopters) and 29 horizontal strabismus cases (angles in the range 12-20 prism diopters). The first step was an inferior oblique myectomy in the SOP cases and a single rectus recession in the horizontal cases. After intraoperative assessment, 31% (16/51) needed additional muscle surgery. After 6 months of follow up, the overall reoperation rate was 9%. The technique was well tolerated by all patients. Conclusion: Stepped strabismus surgery is a useful technique for small to moderate angle strabismus cases with the potential for reducing the number of extraocular muscles operated on without compromising the surgical outcome.
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关键词
anesthesia,anesthetics,intravenous,oculomotor muscles/surgery,propofol,retrospective studies,strabismus/surgery
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