What is strabismus surgery?
Strabismus is a loss of eye parallelism or the ability to move in a coordinated manner in different directions. For this to occur, the set of muscles that move the eyes, six in each eye, must have a balance in their forces; both in the active forces, which are those that move the eyes, and in the passive forces, which are those that oppose this movement. If the balance is adequate, the eyes move in a coordinated manner and maintain the intended position. If this balance of force is not adequate or there is a loss of parallelism or a defect in the ocular rotation movement, strabismus surgery restores the balance of both active and passive forces to the ocular muscles, so that parallelism and coordination of movement in all directions is restored.
Can both eyes be operated at the same time?
Yes, both eyes can be operated on at the same time and in fact most of the time they should be. The research work that we have developed in this center has consisted of an individual analysis of each of the ocular muscles to know if one or more muscles of one eye or both eyes should be operated on. This diagnosis, which is made at the time of the operation, is essential to achieve a balance of forces.
What type of anesthesia will be used?
The anesthesia we use for strabismus surgery should always be general anesthesia, using muscle relaxants. What we must do before and during the intervention is a diagnosis of the alterations, of the elasticity and muscle length. This investigation can only be done if the patient is with adequate muscle relaxation, and this can only be achieved through general anesthesia.
Does the expected result imply a definitive solution?
The definitive solution will be achieved progressively. Strabismus, especially infantile strabismus, is a process that is affected by maturation. So, from birth or the first months of life, when the first cases of strabismus appear, physical and all kinds of changes take place in the organism that also cause the ocular musculature and the eyeballs to change. So, surgery performed at six to eight months of age may require further action later on due to the physical changes that will occur. The basic objective is to always keep the eyes aligned and coordinated in their movements and when new components of imbalance appear, they can be rectified in time. The critical age groups in which variations that need treatment may appear are: between zero and nine years, for a basic treatment; between fifteen and twenty years, a stage of adolescence very characteristic of some changes; and the stage of thirty-five to forty years, with the onset of presbyopia.
What are the risks involved in surgery?
There are very few risks in strabismus surgery when it is performed by an expert who has reached an adequate diagnosis and who knows how to implement that diagnosis with inter-operative tests. The risks of infection are trivial, and are normally always corrected with post-operative treatment. More complex risks would basically come from a defect in the suture, which is known as a slipped muscle or lost muscle; it is a disinsertion of the newly operated muscle and therefore a situation of paralysis that must be replaced as soon as possible.
When can normal activities be resumed after surgery?
The recovery of normal activity depends very much on age; young children recover much faster than adults. In general, in children between six months and four years of age, they are back to normal within twenty-four hours; adults take between two or three days and sometimes it can take up to a week, everything obviously depends on the normal activity that the person performs and the demands he/she has. Although the eyes may appear reddened, the discomfort has disappeared after twenty-four to forty-eight hours, which does not prevent the performance of normal activities, except for the aesthetic aspect of the redness of the surgery.