Strabismus surgery in topical anaesthesia with intraoperative suture adjustment in Graves' orbitopathy.

IF 3 3区 医学 Q1 OPHTHALMOLOGY Acta Ophthalmologica Pub Date : 2024-10-23 DOI:10.1111/aos.16784
Olav H Haugen, Anne Elisabeth Christensen Mellgren, Maren Norli, Hans Olav Ueland
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Abstract

Purpose: To report the results of strabismus surgery in a series of patients with Graves' orbitopathy (GO), using topical anaesthesia with intraoperative suture adjustment.

Methods: All first-time strabismus surgeries in patients with GO in our department during the years 2014-2021 (n = 45) were assessed retrospectively. Among these, 31% came from outside our health region due to increased complexity of the strabismus condition. Orbital decompression surgery had been carried out in 58% of the patients prior to strabismus surgery. Patients with less than 2 months of follow-up were excluded from the study. Median follow-up time was 22 months.

Results: Among the total patient material, 37 (82%) could be operated with topical anaesthesia with intraoperative suture adjustment. There were no cases with triggering of the oculo-cardiac reflex during the procedure. Among the 36 patients operated with topical anaesthesia and follow-up time ≥2 months, 11 (31%) needed further surgery. Late overcorrection after recession of the inferior rectus was seen in 19%. At the last control examination, 32 (89%) were diplopia-free in primary and down-gaze position, either with or without weak prisms.

Conclusion: Strabismus surgery in topical anaesthesia with intraoperative suture adjustment appears to be a suitable and safe procedure in most patients with GO, including difficult and complex cases. The patients should be informed about the possibility of additional surgery and/or post-operative need for prism glasses.

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在局部麻醉下进行斜视手术,术中调整巴塞杜氏眼眶病的缝合线。
目的:报告一系列巴塞杜氏眼眶病(Graves's orbitopathy,GO)患者使用局部麻醉术中缝合调整的斜视手术效果:回顾性评估2014-2021年间我科所有首次接受斜视手术的GO患者(n = 45)。其中,31%的患者由于斜视病情更加复杂而来自本医疗区域以外。58%的患者在斜视手术前接受过眼眶减压手术。随访时间不足 2 个月的患者被排除在研究之外。中位随访时间为22个月:在所有患者资料中,有 37 例(82%)可以通过局部麻醉和术中缝合调整进行手术。手术过程中没有触发眼-心反射的病例。在采用局部麻醉且随访时间≥2 个月的 36 例患者中,有 11 例(31%)需要进一步手术。19%的患者在下直肌回缩后出现晚期过度矫正。在最后一次对照检查中,32例(89%)患者在主视位和下视位无复视,有或无弱棱镜:结论:在局部麻醉下进行斜视手术,并在术中调整缝合线,对于大多数GO患者,包括疑难和复杂病例,似乎是一种合适而安全的手术。应告知患者可能需要进行额外手术和/或术后需要佩戴棱镜。
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来源期刊
Acta Ophthalmologica
Acta Ophthalmologica 医学-眼科学
CiteScore
7.60
自引率
5.90%
发文量
433
审稿时长
6 months
期刊介绍: Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.
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