Adjustment under topical anaesthesia in children
Reviewed by Fiona Rowe

This is a study of 19 cases of strabismus surgery using topical aesthetic and intraoperative adjustment in selected children. The study included 14 males and five females with mean age of 12.68 ±2.5 years (range 8-16). Five were esotropia and 14 exotropia. Overall, mean preoperative angle was 24.21 ±11.2PD at distance and 22.11 ±11.05PD at near. Seventeen of 19 patients (89%) remained comfortable during surgery. Two needed IV injection of propofol. Overall mean postoperative angle at six months follow-up was 4.11 ±2.87PD at distance and 3.58 ±2.95PD at near. Fourteen of 19 (74%) needed intraoperative adjustment and mean adjustment angle was 4.5PD. Seventeen (89%) reached their target angle (success rate). One was over and one was under corrected. The authors conclude that this approach is tolerable with good outcomes in well-selected children. Assessment of the child is fundamental to determine collaboration during surgery.

Topical anesthesia in children with intraoperative adjustable strabismus surgery.
Franco F, Bolletta E, Mancioppi S, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2019;56:173-7.