ABSTRACT
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.
Subject(s)
Graves Ophthalmopathy , Strabismus , Anesthesia, Local , Graves Ophthalmopathy/complications , Graves Ophthalmopathy/surgery , Humans , Oculomotor Muscles/surgery , Ophthalmologic Surgical Procedures/methods , Pain/complications , Pain/surgery , Retrospective Studies , Strabismus/complications , Strabismus/surgery , Treatment OutcomeABSTRACT
By extracting data from our medical record database concerning cataract complications a clinical audit was performed. The statistics programme in our database delivered the medical records. Each complication was carefully investigated at a clinical audit in order to improve the future surgical outcome. Recent years of clinical audit has helped to improve the outcome of cataract surgery at our clinic in the form of fewer complications. The data are compared to EUREQUO. Furthermore, parallels to other medical specialities are drawn.