Résumé
Purpose: The authors attempted to identify the determinants of ocular deviation in a population of patients with esotropia under general anesthesia.
Methods: Forty-one patients with esotropia were included. Horizontal ocular deviation was evaluated by the photographic Hirschberg test both in the awakened state and under general anesthesia before surgery. Changes in ocular deviation were measured and a multivariate analysis was used to assess its clinical determinants.
Results: The mean age (+/- standard deviation [SD]) of study subjects was 13 +/- 11 years and 51% were females. The mean spherical equivalent refraction of the right eye was 2.44 +/- 2.50 diopters ( D), with no significant difference between eyes (P = .26). The mean ocular deviation changed significantly, from 33.5 +/- 12.5 prism diopters (PD) at preoperative examination to 8.8 +/- 11.4 PD under general anesthesia (P = .0001). The changes in ocular deviation positively correlated with the preoperative ocular deviation (correlation coefficient r = 0.59, P = .0001) and negatively correlated with patient age (correlation coefficient r = -0.53, P = .0001). These two determinants remained significant after multivariate adjustment of the following variables: preoperative ocular deviation; age; gender; spherical equivalent refraction; and number of previous strabismus surgeries (model r(2) = 0.49, P = .0001).
Conclusions: The ocular position under general anesthesia was reported as a key factor in the surgical treatment of subjects with esotropia; therefore, its clinical determinants were assessed. The authors observed that preoperative ocular deviation and patient age were the main factors that influenced the ocular position under general anesthesia.