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Ocular alignment changes after general anesthesia may predict surgical results
J Pediatr Ophthalmol Strabismus .2011;doi:10.3928/01913913-20110517-01.
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Changes in ocular alignment under general anesthesia in children with intermittent exotropia correlated strongly with preoperative strabismus angles and helped predict surgical outcomes, a study found.
"If certain measurements obtained under general anesthesia can predict surgical results, intraoperative adjustment may be possible, even in children," the study authors said.
A study group included 40 children with exotropia and a mean age of 6.7 years. A control group comprised 20 patients with a mean age of 6.3 years and no exotropia who underwent epiblepharon surgery under general anesthesia.
Investigators obtained digital photographs before and after general anesthesia was administered with the children in the primary supine position. At 1 day and 1 year after surgery, preoperative angle of deviation was compared with changes in the anatomic interpupillary distance after general anesthesia.
Study results showed that all children in both groups had increased anatomic interpupillary distance after general anesthesia. Average changes in eye position were 3.78% in the study group and 3.15% in the control group; the between-group difference was not statistically significant.
Children in the study group showed an appreciable correlation between preoperative distance deviation and change in eye position (P < .001).
Five of seven children whose ocular alignment changes were outside the 80% confidence interval for expected outcomes had poor results 1 day after surgery; four of the seven children had poor results at 1 year.