title: Proparacaine-Induced Mydriasis During Strabismus Surgery.
abstract: OBJECTIVE
  To evaluate the mydriatic effect of proparacaine hydrochloride (PH) in children undergoing strabismus surgery under general anesthesia (GA).
  
  
  METHODS
  This was a pilot, prospective, non-randomized, self-controlled interventional study. Nine children with esotropia or exotropia undergoing horizontal muscle squint surgery under GA at a tertiary eye care center were included. The six Group 1 patients underwent both eye surgeries, while the three Group 2 patients underwent single eye surgery. PH was instilled in one eye of Group 1 patients and both eyes of Group 2 patients. Change in pupil diameter (PD) was analyzed as the main outcome measure.
  
  
  RESULTS
  Mean age of the patients was 4.67 ± 2.64 years. In the study eyes, mean average baseline PD was 1.59 ± 0.40 mm (range: 1.06-2.37), while postoperative average PD was 3.99 ± 1.34 mm (range: 1.79-6.02). The mean baseline PC had increased from 5.51 ± 1.09 mm to 12.6 ± 3.58 mm at the end of the surgery. PD and PC increased in all of the study eyes while no change in PD or PC was seen in the control eyes of either of the groups. The dilated pupil was skewed horizontally towards the muscle being operated upon in all of the study eyes.
  
  
  CONCLUSIONS
  PH has a mydriatic effect of its own. It penetrates through the bare sclera and leads on to skewed dilation of the pupil. Surgeons should consider this effect while judging pupil alignment at the end of the surgery.
authors.affiliation: a Dr. R. P. Centre for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Brijesh
authors.initials: B
authors.lastname: Takkar
authors.affiliation: a Dr. R. P. Centre for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Sharma
authors.affiliation: a Dr. R. P. Centre for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Nripen
authors.initials: N
authors.lastname: Gaur
authors.affiliation: a Dr. R. P. Centre for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Ashutosh Kumar
authors.initials: AK
authors.lastname: Singh
authors.affiliation: a Dr. R. P. Centre for Ophthalmic Sciences , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Ramachandran
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000601:surgery; D005099:Exotropia / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D015878:Mydriasis / Q000139:chemically induced*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D010865:Pilot Projects; D011430:Propoxycaine / Q000494:pharmacology*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D013285:Strabismus / Q000601:surgery*
chemical_list: D000779:Anesthetics, Local; C005717:proxymetacaine; D011430:Propoxycaine
keywords: Mydriasis; proparacine; strabismus surgery; topical anesthesia