TY - JOUR

T1 - Topical anaesthesia in strabismus surgery for Graves’ orbitopathy

T2 - a comparative study of 111 patients

AU - Boulakh, Lena

AU - Toft-Petersen, Anne Pernille

AU - Severinsen, Martin

AU - Toft, Peter Bjerre

AU - Ellervik, Christina

AU - Buch Hesgaard, Helena

AU - Heegaard, Steffen

N1 - The authors would like to thank Troels Vinding, MD, DM. Sci, who performed all the surgeries. The authors would also like to thank the Synoptik foundation, Ole Kirk's foundation, Helsefonden and Mikael Bondum for the generous financial support. The funding organizations had no role in the design or conduct of this research.

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - diplopia

KW - Graves’ eye disease

KW - Graves’ ophthalmopathy

KW - Graves’ orbitopathy

KW - outcomes

KW - strabismus surgery

KW - thyroid eye disease

KW - topical anaesthesia

U2 - 10.1111/aos.15024

DO - 10.1111/aos.15024

M3 - Journal article

C2 - 34532987

AN - SCOPUS:85115012874

VL - 100

SP - 447

EP - 453

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

SN - 1755-375X

IS - 4

ER -