Single-stage surgery for symptomatic small-angle strabismus under topical anaesthesia

Abstract

ObjectiveTo report outcomes of single-stage surgery under topical anaesthesia for the treatment of small-angle strabismus. DesignCase series. ParticipantsThirteen patients, 7 males and 6 females, with a median age of 32 years (range, 20–59 years) were included. MethodsPatients with symptomatic small-angle strabismus with stable deviations of no more than 20 prism diopters (PD) in horizontal and 10 PD in vertical were consecutively recruited from the Eye and ENT Hospital of Fudan University between January 2010 and April 2012. Single-stage surgery was performed under topical anaesthesia. Outcome measures were PD, Amblyopia and Strabismus Questionnaire (ASQE) scores, and subjective reduction of symptoms. ResultsThe median duration of symptoms was 40 months (range, 6–96 months). Nine patients had horizontal deviations, 3 had vertical deviations, and 1 had an exodeviation combined with a vertical deviation. All surgeries were completed without complications, and no patients experienced significant discomfort. All patients reported elimination of symptoms on postoperative day 1. Two patients required a second procedure at 1 week because of a return of symptoms. At 6-month follow-up, no patient reported recurrence of symptoms. The overall ASQE score improved from 70 preoperatively to 96 postoperatively (p = 0.001). ConclusionsThese results suggest single-stage surgery under topical anaesthesia is an effective treatment for small-angle strabismus. A large, randomized, prospective study to confirm these findings is warranted.