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. 2009;64(4):303-8.
doi: 10.1590/s1807-59322009000400006.

Results of monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus

Tatiana Millán  1 , Keila Monteiro de Carvalho, Nilza Minguini
Affiliations

Results of monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus

Tatiana Millán et al. Clinics (Sao Paulo). 2009.

Abstract

Objective: To evaluate the results of monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus.

Introduction: Monocular surgery may preserve some muscles if a repeat operation is required, may help to avoid the exposure of the dominant eye to the inherent risks of a surgical procedure and may reduce surgical time.

Methods: We evaluated ninety-two consecutive patients who underwent monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus (angle of 40 prism diopters or greater). Patients were divided into group 1- esotropia and group 2 -exotropia. The postoperative follow-up was at 6 months, when the residual deviation was evaluated. In cases of residual deviations of over 15 PD (prism diopter), a second procedure was indicated.

Results: In all patients with preoperative deviations up to 60 PD, residual deviations were under 15 PD. Some patients with preoperative deviations of 65 PD (two in group 1 and four in group 2) and all patients with deviations over 65 PD had residual deviations over 15 PD. The 13 patients who underwent a second procedure experienced successful outcomes. Our ROC curve analysis showed that the cutoff point for obtaining a successful surgical result was 62.5 PD. No patient presented with a major limitation in respect of ocular movement.

Conclusions: Monocular surgery under peribulbar anesthesia can be an alternative for horizontal large-angle strabismus given deviations of up to 60 PD. Monocular surgery did not result in successful outcomes for deviations of over 65 PD.

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Figures

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Figure 1 -
ROC Curve
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