Topical anesthesia strabismus surgery.

Introduction: Topical anesthesia strabismus surgery is practised in selected surgical situations in the management of adult strabismus. Careful patient selection and patient co-operation throughout the surgery forms the crux of successfully completing the procedure.

Objective: To discuss and identify the scope of topical anesthesia in strabismus surgery based on the current level of evidence.

Methods: A literature search of articles pertaining to the use of topical strabismus surgery was carried out and summarized. The pre-operative considerations and patient counseling, timing of administration of topical anaesthetic, nuances in the surgical technique, benefits and limitations were evaluated.

Results: The patients with relatively smaller angle of deviation, single eye surgery and patients who have not had previous strabismus surgery were preferred candidates for topical strabismus surgery. It offers the additional advantage of performing an adjustable suture technique with a one stage adjustment.

Discussion: A pre-operative office room force duction test (FDT) is important both for assessing patient co-operation and from the patient perspective with regards to the level of comfort or discomfort they may experience. The results with regards to the successful completion of the procedure and its benefits and limitations support the use of topical anesthesia in strabismus surgery in a select few.

Conclusion: This review concludes that topical anesthesia strabismus surgery can be the procedure of choice in select surgical situations in the management of adult strabismus.