Chapter 114 - Strabismus surgery

Summary

Extraocular muscle surgery is performed to correct strabismus. Strabismus includes any horizontal, vertical, or torsional misalignment of the eyes and can affect either children or adults. The disease can be categorized as congenital, acquired, restrictive, or paralytic. The goal of surgery is to restore the eyes to their normal anatomical position and to maximize the potential for binocularity. Other indications include eliminating diplopia, relieving mechanical restriction or restoring normal head position. In cases of nystagmus, surgery has the potential to improve vision. Either individual or multiple extroacular muscles may be operated upon during surgery; bilateral procedures are common. In selective cases, adjustable suture surgery may be performed.

Strabismus surgery is most commonly performed under general anesthesia. However, in selected cases, local anesthesia may be preferred. Topical anesthesia may be used for standard “muscle weakening” procedures for surgical patients who are good candidates for conscious sedation. Retrobulbar or peribulbar anesthesia may be useful for strabismus correction if strabismus correction surgery is only being performed in one eye under monitored anesthesia.