Our Summary

This study examined the effectiveness of a specific kind of eye surgery in children. The surgery, called strabismus surgery, is used to correct misaligned eyes. In this study, the surgeons made adjustments during the surgery based on tests done with a prism. The children were awake during the surgery, which was done using a local anesthetic.

They found that the average age of the children having the surgery was around 13 years old. Before the surgery, the children’s eyes were misaligned by an average of about 24 prism diopters. Six months after the surgery, the average misalignment had decreased to about 4 prism diopters.

The vast majority of the children (89%) were comfortable during the surgery. Only two children needed to be sedated. The surgery was considered successful in 89% of cases, defined as having a residual misalignment of 8 prism diopters or less six months after the surgery.

The authors concluded that this type of surgery could be a good alternative to general anesthesia for selected children who are able to collaborate during the procedure. However, they also indicated that careful evaluation of the child and parents is important in predicting whether or not the child will be able to cooperate during the surgery.

FAQs

  1. What is strabismus surgery and how is it performed?
  2. What were the results of the study regarding the effectiveness of strabismus surgery?
  3. What factors determine if a child is a good candidate for strabismus surgery under local anesthesia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to make sure to follow all pre-operative instructions provided by the surgeon. This can include things like avoiding certain medications, fasting before the surgery, and arranging for transportation to and from the surgical facility. Following these instructions can help ensure the surgery goes smoothly and leads to the best possible outcome.

Suitable For

Patients who are typically recommended strabismus surgery are those who have misaligned eyes, also known as strabismus, that cannot be corrected with other treatments such as glasses, eye exercises, or vision therapy. Patients may also be recommended for surgery if their misalignment is causing symptoms such as double vision, eye strain, or headaches. Additionally, patients who have a significant misalignment that affects their appearance or self-confidence may also be recommended for surgery. In the study mentioned above, the children who underwent strabismus surgery had an average misalignment of about 24 prism diopters before the surgery, indicating a significant misalignment that warranted surgical intervention.

Timeline

Overall, the timeline of a patient’s experience before and after strabismus surgery can be summarized as follows:

Before surgery:

  1. Consultation with an ophthalmologist to determine the need for surgery
  2. Pre-surgical tests and evaluations to assess the severity of misalignment
  3. Decision-making process with the patient and/or parents regarding the surgery
  4. Scheduled surgery date and instructions for pre-operative care

During surgery:

  1. Local anesthesia administered to the patient
  2. Adjustment of the eye muscles based on prism tests
  3. Monitoring of the patient’s comfort and cooperation during the surgery
  4. Surgical procedure completed within a certain timeframe

After surgery:

  1. Post-operative care instructions provided to the patient and/or parents
  2. Follow-up appointments scheduled to monitor healing progress
  3. Gradual improvement in eye alignment over the following weeks and months
  4. Assessments of the success of the surgery based on residual misalignment

In conclusion, strabismus surgery involves a thorough pre-operative evaluation, a precise surgical procedure, and a period of recovery and monitoring to ensure the best possible outcome for the patient.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery?
  2. How long is the recovery period after the surgery?
  3. Will there be any restrictions on activities following the surgery?
  4. How successful is this type of surgery in correcting misaligned eyes in children?
  5. Are there any alternative treatment options to consider before opting for surgery?
  6. How many times have you performed this type of surgery, and what is your success rate?
  7. Will my child need to wear an eye patch or use eye drops after the surgery?
  8. How soon after the surgery will we see improvement in my child’s eye alignment?
  9. Will my child need follow-up appointments after the surgery, and if so, how often?
  10. What can we expect in terms of long-term outcomes and potential need for additional surgeries in the future?

Reference

Authors: Franco F, Bolletta E, Mancioppi S, Franco E, Migliorelli A, Perri P. Journal: J Pediatr Ophthalmol Strabismus. 2019 May 22;56(3):173-177. doi: 10.3928/01913913-20190208-02. PMID: 31116865