title: Selection of patients and results of 25 years of topical anesthesia and adjustable suture surgery.
abstract: OBJECTIVE
  The author has used adjustable suture techniques either in the operating room with topical anesthesia or at a later time after retrobulbar or general anesthesia for over 25 years. Careful selection of patients is essential to the success of this technique. It is the purpose of this paper to report the selection criteria used and to compare the results of the two methods utilized.
  
  
  METHODS
  One hundred eighty-three patients were included in this study: 123 were operated upon with topical anesthesia. For comparison, sixty patients were included who had adjustment later in the day or the next day after having retrobulbar or general anesthesia. Both horizontal and vertical strabismus cases were included.
  
  
  RESULTS
  Adjustable techniques done in the operating room or at a later time have both shown significant improvement in the strabismus angle following one operation in 86% of the cases. Diplopia was eliminated in 63% of patients with this complaint. (63% and 64.5% in the two groups, respectively). Seventeen of 123 patients having topical anesthesia (13.8%) required a second operation, and 8 of 60 (13.3%) of those having a later adjustment needed further surgery.
  
  
  CONCLUSIONS
  Careful selection of patients undergoing strabismus surgery allows successful topical muscle adjustment in the operating room with results similar to adjustments done following retrobulbar or general anesthesia at a later time.
authors.affiliation: From Houston Eye Associates and The University of Texas Medical School, and.
authors.forename: Malcolm L
authors.initials: ML
authors.lastname: Mazow
authors.forename: Jack
authors.initials: J
authors.lastname: Fletcher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D002648:Child; D004867:Equipment Design; D005133:Eye Movements; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D055815:Young Adult
keywords: adjustment; retrobulbar; strabismus surgery; sutures; topical anesthesia