title: Topical anesthesia in strabismus surgery: a review of 101 cases.
abstract: OBJECTIVE
  To analyze the results over a 10-year period with a different type of strabismus surgery performed with topical anesthesia, to describe the differences in technique compared with surgery performed with general anesthesia, and to detail current indications and technical changes made according to the experience accrued during these years.
  
  
  METHODS
  A total of 101 patients undergoing strabismus surgery with topical anesthesia in a single hospital were analyzed. These patients were randomly selected from a total of 567 patients who had undergone extra-ocular muscle surgery in the past 10 years.
  
  
  RESULTS
  A good result was obtained (squint angle < 10 prism diopters and absence of diplopia) in 95% of patients immediately after surgery and in 85% at final follow-up (mean follow-up: 3.1 years). The mean operating time for each muscle was 29 minutes. Surgery was well tolerated in every patient. Conversion to general anesthesia was not necessary in any case. Atropine was used in three patients (3%) because of induction of the vagal reflex.
  
  
  CONCLUSIONS
  Topical anesthesia in strabismus surgery is a useful technique in the treatment of extraocular muscle pathology, with few limitations. Appropriate monitoring by an anesthetist is vital to ensure adequate control of pain and possible side effects and to enable conversion to general anesthesia. The oculocardiac reflex is infrequent. For experienced strabismus surgeons, the total surgical time is comparable with topical and general anesthesia.
authors: Gergorio Marańon University Hospital, Madrid, Spain.
authors: Olga
authors: O
authors: Seijas
authors: Pilar
authors: P
authors: Gómez de Liaño
authors: Pilar
authors: P
authors: Merino
authors: Clare J
authors: CJ
authors: Roberts
authors: Rosario
authors: R
authors: Gómez de Liaño
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D013748:Tetracaine / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D013748:Tetracaine; D011343:Procaine; C005298:benoxinate