Document Detail


Surgery for esotropia under topical anesthesia.
MedLine Citation:
PMID:  20570361     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare a surgically adjusted dose of strabismus surgery using topical anesthesia in cooperative patients with dosage guidelines adapted to the surgeon's personal technique using sub-Tenon's anesthesia. DESIGN: Randomized, controlled, single-site clinical trial. PARTICIPANTS: Sixty patients with nonparalytic, nonrestrictive esotropia who were cooperative for surgery under topical anesthesia. METHODS: Twenty-eight patients were assigned to topical anesthesia, and 32 patients were assigned to sub-Tenon's anesthesia. Visual acuity, refraction, and deviation angle were determined in all patients preoperatively and postoperatively, and stereoacuity was measured postoperatively. Deviation angle was measured by simultaneous and alternate prism and cover test, and stereoacuity was measured using Randot circles (Stereo Optical Co., Chicago, IL). The amount of surgery under topical anesthesia was adjusted intraoperatively. MAIN OUTCOME MEASURES: The amount of surgery used in the 2 treatment groups (measured in millimeters and millimeter/degree of deviation angle) and 6-month motor and stereoacuity outcomes. RESULTS: Patients in the topical group required 3.2 mm less surgery on average than those in the sub-Tenon's group (5.9 and 9.1 mm, respectively; 0.4 and 0.6 mm of recession/degree, respectively) (P<0.01). Motor success (84% and 75%, respectively, P=0.38) and stereoacuity (339.6 and 323.9 arc seconds, respectively, P=0.87) at 6 months were similar in the 2 groups. CONCLUSIONS: Topical anesthesia requires a smaller amount of surgery and number of operated muscles to correct esotropia compared with classic surgery guidelines adapted to the surgeon's personal technique.
Authors:
Jaime Tejedor; Consuelo Ogallar; José M Rodríguez
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-06-08
Journal Detail:
Title:  Ophthalmology     Volume:  117     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1883-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Ophthalmology, Hospital Ramón y Cajal, Madrid, Spain. jtejedor.hrc@salud.madrid.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anesthesia, Local / methods*
Anesthetics, Local / administration & dosage
Esotropia / physiopathology,  surgery*
Female
Humans
Lidocaine / administration & dosage
Male
Middle Aged
Oculomotor Muscles / physiopathology,  surgery*
Ophthalmologic Surgical Procedures*
Procaine / administration & dosage,  analogs & derivatives
Refraction, Ocular / physiology
Tetracaine / administration & dosage
Visual Acuity / physiology
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine; 59-46-1/Procaine; 94-24-6/Tetracaine; 99-43-4/benoxinate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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