Topical anaesthesia in strabismus surgery for Graves' orbitopathy: a comparative study of 111 patients.

Autor: Boulakh L; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark., Toft-Petersen AP; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark., Severinsen M; EuroEyes, Copenhagen, Denmark., Toft PB; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Ellervik C; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Laboratory Medicine, Harvard Medical School, Boston, MA, USA.; Department of Data Support, Region Zealand, Sorø, Denmark., Buch Hesgaard H; Department of Ophthalmology, Sahlgrenska University Hospital, Gothenburg, Sweden.; Institute of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden., Heegaard S; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Pathology, Rigshospitalet-Glostrup, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2022 Jun; Vol. 100 (4), pp. 447-453. Date of Electronic Publication: 2021 Sep 16.
DOI: 10.1111/aos.15024
Abstrakt: Purpose: To evaluate the tolerability and usability of topical anaesthesia in single rectus muscle recession for strabismus caused by Graves' orbitopathy (GO). To compare the perioperative pain score and surgical outcome between GO patients and non-GO patients.
Methods: A retrospective comparative study of consecutive single rectus muscle recession performed under topical anaesthesia was carried out. All patients scheduled for one-stage single rectus muscle recession under topical anaesthesia were included. Numerical visual analogue pain score scale (NVAS) points, rates of motor success (horizontal deviation < 8 prism diopters (PD) and vertical deviation ≤ 6 PD) and sensory success (no diplopia without prisms), complications and postoperative adjustment frequencies were compared between GO and non-GO patients.
Results: A total of 111 patients were included. The mean perioperative pain scores were 2.3 (SD ± 1.3) in GO and 1.6 (SD ± 1.1) in non-GO patients (p = 0.06 adjusted for gender). The postoperative mean alignments in GO and non-GO patients were 2 versus 3 PD horizontally and 1 versus 1 PD vertically respectively. Both motor and sensory success rates were 98% in GO patients and 94% versus 93% in non-GO patients. Adjustments as a second procedure the day after surgery was performed in 10% of the GO patients and 15% of the non-GO patients. The oculocardiac reflex was not triggered in any of the GO patients.
Conclusion: Topical anaesthesia in single muscle recession for GO is safe, well-tolerated and gives comparable surgical outcomes to those achieved in non-GO patients.
(© 2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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