Stepped Strabismus Surgery

Amr Elkamshoushy, Ahmed Kassem Department of Ophthalmology, Faculty of Medicine, University of Alexandria, Alexandria, EgyptCorrespondence: Amr ElkamshoushyDepartment of Ophthalmology, Faculty of Medicine, University of Alexandria, Alazarita, Alexandria, EgyptEmail elkamshoushy@gmail.comPurpose: To...

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Autores principales:	Elkamshoushy A, Kassem A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	anesthesia anesthetics intravenous oculomotor muscles/surgery propofol retrospective studies strabismus/surgery Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/3f51acc30f5b4edf899ee0b5ffe1390c
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spelling	oai:doaj.org-article:3f51acc30f5b4edf899ee0b5ffe1390c2021-12-02T17:35:10ZStepped Strabismus Surgery1177-5483https://doaj.org/article/3f51acc30f5b4edf899ee0b5ffe1390c2021-04-01T00:00:00Zhttps://www.dovepress.com/stepped-strabismus-surgery-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Amr Elkamshoushy, Ahmed Kassem Department of Ophthalmology, Faculty of Medicine, University of Alexandria, Alexandria, EgyptCorrespondence: Amr ElkamshoushyDepartment of Ophthalmology, Faculty of Medicine, University of Alexandria, Alazarita, Alexandria, EgyptEmail elkamshoushy@gmail.comPurpose: To present stepped strabismus surgery as a novel technique in cases of small to moderate angle strabismus.Methods: Retrospective chart review of cases of stepped strabismus surgery from 2010 untill 2018. In stepped surgery, the first muscle is operated on under rapid induction-recovery IV propofol infusion. Patient is assessed in the OR. If deemed necessary, other muscles are operated on under general anesthesia. No adjustable sutures are used.Results: The technique was used in 22 cases of superior oblique palsy (SOP) (primary position hypertropia in the range of 12– 25 prism diopters) and 29 horizontal strabismus cases (angles in the range 12– 20 prism diopters). The first step was an inferior oblique myectomy in the SOP cases and a single rectus recession in the horizontal cases. After intraoperative assessment, 31% (16/51) needed additional muscle surgery. After 6 months of follow up, the overall reoperation rate was 9%. The technique was well tolerated by all patients.Conclusion: Stepped strabismus surgery is a useful technique for small to moderate angle strabismus cases with the potential for reducing the number of extraocular muscles operated on without compromising the surgical outcome.Keywords: anesthesia, anesthetics, intravenous, oculomotor muscles/surgery, propofol, retrospective studies, strabismus/surgeryElkamshoushy AKassem ADove Medical Pressarticleanesthesiaanestheticsintravenousoculomotor muscles/surgerypropofolretrospective studiesstrabismus/surgeryOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1783-1789 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anesthesia anesthetics intravenous oculomotor muscles/surgery propofol retrospective studies strabismus/surgery Ophthalmology RE1-994
spellingShingle	anesthesia anesthetics intravenous oculomotor muscles/surgery propofol retrospective studies strabismus/surgery Ophthalmology RE1-994 Elkamshoushy A Kassem A Stepped Strabismus Surgery
description	Amr Elkamshoushy, Ahmed Kassem Department of Ophthalmology, Faculty of Medicine, University of Alexandria, Alexandria, EgyptCorrespondence: Amr ElkamshoushyDepartment of Ophthalmology, Faculty of Medicine, University of Alexandria, Alazarita, Alexandria, EgyptEmail elkamshoushy@gmail.comPurpose: To present stepped strabismus surgery as a novel technique in cases of small to moderate angle strabismus.Methods: Retrospective chart review of cases of stepped strabismus surgery from 2010 untill 2018. In stepped surgery, the first muscle is operated on under rapid induction-recovery IV propofol infusion. Patient is assessed in the OR. If deemed necessary, other muscles are operated on under general anesthesia. No adjustable sutures are used.Results: The technique was used in 22 cases of superior oblique palsy (SOP) (primary position hypertropia in the range of 12– 25 prism diopters) and 29 horizontal strabismus cases (angles in the range 12– 20 prism diopters). The first step was an inferior oblique myectomy in the SOP cases and a single rectus recession in the horizontal cases. After intraoperative assessment, 31% (16/51) needed additional muscle surgery. After 6 months of follow up, the overall reoperation rate was 9%. The technique was well tolerated by all patients.Conclusion: Stepped strabismus surgery is a useful technique for small to moderate angle strabismus cases with the potential for reducing the number of extraocular muscles operated on without compromising the surgical outcome.Keywords: anesthesia, anesthetics, intravenous, oculomotor muscles/surgery, propofol, retrospective studies, strabismus/surgery
format	article
author	Elkamshoushy A Kassem A
author_facet	Elkamshoushy A Kassem A
author_sort	Elkamshoushy A
title	Stepped Strabismus Surgery
title_short	Stepped Strabismus Surgery
title_full	Stepped Strabismus Surgery
title_fullStr	Stepped Strabismus Surgery
title_full_unstemmed	Stepped Strabismus Surgery
title_sort	stepped strabismus surgery
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/3f51acc30f5b4edf899ee0b5ffe1390c
work_keys_str_mv	AT elkamshoushya steppedstrabismussurgery AT kassema steppedstrabismussurgery
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Stepped Strabismus Surgery

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