OBJECTIVE: To evaluate the results of monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus. INTRODUCTION: Monocular surgery may preserve some muscles if a repeat operation is required, may help to avoid the exposure of the dominant eye to the inherent risks of a surgical procedure and may reduce surgical time. METHODS: We evaluated ninety-two consecutive patients who underwent monocular surgery under peribulbar anesthesia for large-angle horizontal strabismus (angle of 40 prism diopters or greater). Patients were divided into group 1- esotropia and group 2 -exotropia. The postoperative follow-up was at 6 months, when the residual deviation was evaluated. In cases of residual deviations of over 15 PD (prism diopter), a second procedure was indicated. RESULTS: In all patients with preoperative deviations up to 60 PD, residual deviations were under 15 PD. Some patients with preoperative deviations of 65 PD (two in group 1 and four in group 2) and all patients with deviations over 65 PD had residual deviations over 15 PD. The 13 patients who underwent a second procedure experienced successful outcomes. Our ROC curve analysis showed that the cutoff point for obtaining a successful surgical result was 62.5 PD. No patient presented with a major limitation in respect of ocular movement. CONCLUSIONS: Monocular surgery under peribulbar anesthesia can be an alternative for horizontal large-angle strabismus given deviations of up to 60 PD. Monocular surgery did not result in successful outcomes for deviations of over 65 PD.

OBJETIVO: Comparar os resultados de cirurgias de estrabismo sob anestesia peribulbar e geral em casos de estrabismos horizontais de pequeno e médio ângulo. MÉTODOS: Foram avaliados os prontuários médicos de 84 pacientes com estrabismo horizontal de pequeno e médio ângulo submetidos à cirurgia de estrabismo. Quarenta e dois pacientes foram submetidos à cirurgia sob anestesia peribulbar e quarenta e dois sob anestesia geral. A cirurgia foi considerada satisfatória quando o desvio pós-operatório era de até 10 dioptrias prismáticas (DP). RESULTADOS: A cirurgia foi considerada satisfatória em todos os pacientes. O teste de Mann-Whitney não mostrou diferença no ângulo pré-operatório (p=0,366) nem nos resultados pós-operatórios (p=0,800) entre os dois grupos. Ajustando as variá veis idade e tipo de estrabismo (esotropia e exotropia), o teste ANCOVA (análise de covariância) não mostrou diferença significativa entre os grupos (p=0,368). Não houve complicações decorrentes da cirurgia ou técnica anestésica em nenhum dos grupos. CONCLUSÕES: Este estudo sugere que não há diferença nos resultados pós-operatórios da cirurgia de estrabismo entre anestesia peribulbar e geral em estrabismos horizontais de pequeno e médio ângulo.

PURPOSE: To compare the results of strabismus surgery under peribulbar and general anesthesia in cases of small and moderate angle of horizontal strabismus. METHODS: Medical records of eighty-four patients with small and moderate angle horizontal strabismus who underwent strabismus surgery were reviewed. Forty-two patients were submitted to the surgery under peribulbar anesthesia and forty-two under general anesthesia. The surgery was considered satisfactory when postoperative angle was 10 prism diopters or less. RESULTS: Surgery was satisfactory in all patients. Mann-Whitney test showed no difference in the preoperative angle of deviation (p=0.366) and in the postoperative results (p=0.800) between the two groups. Adjusting for the variables age and type of strabismus (esotropia and exotropia), ANCOVA (analysis of covariance) results showed no statistical difference (p=0.368). There were no complications due to surgery or anesthesia in either group. CONCLUSIONS: This study suggested that there was no difference between the postoperative results of strabismus surgery under peribulbar and general anesthesia in small and moderate angle of horizontal strabismus.