{
  "abstract": "Strabismus surgery is traditionally performed under general anaesthesia (GA), however this is not safe or suitable for many patients. There has been increasing interest in strabismus surgery under local anaesthesia (LA), however large datasets are lacking. We identified 444 operations performed under LA at a tertiary eye centre over a 5-year period from 2020–2024. In-depth analysis of anaesthetic notes was performed for a subset of 153 LA cases and compared to 92 representative GA cases. The most common indications for LA were co-morbidities, weekend scheduling constraints, and COVID restrictions. The widespread use of sedation permitted more complex surgery than has previously been reported with LA alone, including on oblique muscles, vertical recti and re-do surgery. Only one case out of 444 required conversion to GA due to patient anxiety, and 6 cases required top-up of LA due to breakthrough pain. LA with sedation significantly outperformed GA in several parameters including incidence of oculo-cardiac reflex (0% vs. 42.4%), post-operative opioid requirements (0.6% vs. 13.0%), post-operative anti-emetic requirements (7.2% vs 13.0%) and median hospital stay after surgery (118.5 vs. 158 minutes). The LA cohort also had a higher average age (54.3 vs. 41.8) and BMI (28.5 vs. 26.1). Strabismus surgery under LA with sedation is a safe and well-tolerated option, including in patients at higher anaesthetic risk for GA. More widespread use may help to expand the eligible patient population, reduce intra- and post-operative complications, and optimise theatre efficiency and utilisation of resources in a day case setting.",
  "authors": [
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "James Miller"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "Natasha Cox"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "Amal Minocha"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "Lorna Gallagher"
    },
    {
      "affiliations": [
        "Moorfields Eye Hospital, London, UK"
      ],
      "name": "Alasdair Kennedy"
    }
  ],
  "title": "130237 Strabismus surgery under local anaesthesia at a tertiary eye hospital: a 5-year case review",
  "uid": "783bcf34-d1fc-5cbe-9296-fba4de2e11c3"
}