Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia
Purpose: To evaluate the outcomes of large-angle exotropia by single-stage adjustable strabismus surgery (SSASS) under monitored conscious anesthesia. Methods: A prospective study was done in 33 patients above 14 years with ≥40 prism diopters (PD) of exotropia. All patients underwent SSASS under mon...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=12;spage=3592;epage=3597;aulast=Asafali |
| _version_ | 1817985645859045376 |
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| author | Fasna Asafali Muralidhar Rajamani Chidambaram Periannan Sekar Michael Ramamurthy Dandapani |
| author_facet | Fasna Asafali Muralidhar Rajamani Chidambaram Periannan Sekar Michael Ramamurthy Dandapani |
| author_sort | Fasna Asafali |
| collection | DOAJ |
| description | Purpose: To evaluate the outcomes of large-angle exotropia by single-stage adjustable strabismus surgery (SSASS) under monitored conscious anesthesia. Methods: A prospective study was done in 33 patients above 14 years with ≥40 prism diopters (PD) of exotropia. All patients underwent SSASS under monitored conscious anesthesia (topical anesthesia plus intravenous sedation). For deviations of ≤55 PD, two horizontal rectus muscles, and for >55 PD, three rectus muscles were operated and a decision on adjustment/operating on an additional rectus muscle was taken after assessing the alignment. Monitored conscious anesthesia allowed us to check our results after surgery and plan further surgery/adjustment to achieve the desired alignment. Results: Mean preoperative deviation for distance was 52 ± 11.1 PD. The target alignment was achieved with the initial surgical plan in 10/21 patients with <55 PD exotropia and 4/12 patients with >55 PD exotropia, and one patient in each group needed adjustment. The remaining patients needed additional rectus muscle surgery. One patient with >55 PD exotropia needed both adjustment and additional rectus surgery. The success rate for distance correction was 85% at 6 months and 1 year. The overall success rate was 71% at 6 months. Percentage of patients with binocular single vision improved from 31% preoperatively to 78% by 6 months. Incidence of oculocardiac reflex was 6.1%. Conclusion: SSASS under monitored conscious anesthesia is a viable option for large-angle strabismus correction with good patient comfort and safety. |
| first_indexed | 2024-04-13T23:59:47Z |
| format | Article |
| id | doaj.art-e3dcf751d286418eaa68e534e641f475 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-04-13T23:59:47Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-e3dcf751d286418eaa68e534e641f4752022-12-22T02:23:44ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892021-01-0169123592359710.4103/ijo.IJO_85_21Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesiaFasna AsafaliMuralidhar RajamaniChidambaram PeriannanSekar MichaelRamamurthy DandapaniPurpose: To evaluate the outcomes of large-angle exotropia by single-stage adjustable strabismus surgery (SSASS) under monitored conscious anesthesia. Methods: A prospective study was done in 33 patients above 14 years with ≥40 prism diopters (PD) of exotropia. All patients underwent SSASS under monitored conscious anesthesia (topical anesthesia plus intravenous sedation). For deviations of ≤55 PD, two horizontal rectus muscles, and for >55 PD, three rectus muscles were operated and a decision on adjustment/operating on an additional rectus muscle was taken after assessing the alignment. Monitored conscious anesthesia allowed us to check our results after surgery and plan further surgery/adjustment to achieve the desired alignment. Results: Mean preoperative deviation for distance was 52 ± 11.1 PD. The target alignment was achieved with the initial surgical plan in 10/21 patients with <55 PD exotropia and 4/12 patients with >55 PD exotropia, and one patient in each group needed adjustment. The remaining patients needed additional rectus muscle surgery. One patient with >55 PD exotropia needed both adjustment and additional rectus surgery. The success rate for distance correction was 85% at 6 months and 1 year. The overall success rate was 71% at 6 months. Percentage of patients with binocular single vision improved from 31% preoperatively to 78% by 6 months. Incidence of oculocardiac reflex was 6.1%. Conclusion: SSASS under monitored conscious anesthesia is a viable option for large-angle strabismus correction with good patient comfort and safety.http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=12;spage=3592;epage=3597;aulast=Asafalilarge-angle strabismusmonitored conscious anesthesiassass |
| spellingShingle | Fasna Asafali Muralidhar Rajamani Chidambaram Periannan Sekar Michael Ramamurthy Dandapani Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia Indian Journal of Ophthalmology large-angle strabismus monitored conscious anesthesia ssass |
| title | Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia |
| title_full | Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia |
| title_fullStr | Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia |
| title_full_unstemmed | Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia |
| title_short | Outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia |
| title_sort | outcome of large angle exotropia treated by single stage adjustable strabismus surgery with monitored conscious anesthesia |
| topic | large-angle strabismus monitored conscious anesthesia ssass |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=12;spage=3592;epage=3597;aulast=Asafali |
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