Topical anaesthesia in strabismus surgery for Graves' orbitopathy: a comparative study of 111 patients

Lena Boulakh, Anne Pernille Toft-Petersen, Martin Severinsen, Peter Bjerre Toft, Christina Ellervik, Helena Buch Hesgaard, Steffen Heegaard*

*Corresponding author for this work
2 Citations (Scopus)


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.

Original languageEnglish
JournalActa Ophthalmologica
Issue number4
Pages (from-to)447-453
Number of pages7
Publication statusPublished - Jun 2022


  • diplopia
  • Graves’ eye disease
  • Graves’ ophthalmopathy
  • Graves’ orbitopathy
  • outcomes
  • strabismus surgery
  • thyroid eye disease
  • topical anaesthesia


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