The purpose of strabismus surgeries is to loosen or tighten appropriate extraocular muscles, i.e. muscles responsible for the movement of an eye-ball. The required effect is achieved by shortening of the muscle (its strengthening) or its removal and stitching it to the back of its initial position (weakening of the muscle). All strabismus surgeries are performed by a traditional method and there is no possibility of a laser surgery.
Preparation to the surgery
Strabismus surgeries are performed under a general anaesthetic. Usually the surgeries are conducted in an ambulatory mode, i.e. the patient comes on an empty stomach, the surgery is performed and after a few hours the patient is sent home. Based on clinical state of the patient an anaesthetist makes a decision if to sent the patient home.
It is very important to come to the surgery on an empty stomach, i.e. 6 hours after the last meal and drink. If the surgery is to be performed in the morning you must not drink or eat after midnight. If the strabismus surgery is planned for afternoon you are allowed to eat a light breakfast before 8 a.m.
7-14 days after the surgery it is necessary to have additional checkups:
- CBC with peripheral blood smear
- sugar on an empty stomach
- presence of HBs antigen
- blood clotting mechanism: INR, APTT
Before the surgery it is worth to get vaccinated against serum hepatitis. 4 weeks after the first vaccine the second dose is given. A safe level of antibodies is obtained 2 weeks after the second dose. The third vaccine given after 6-12 months will protect you for about 5-8 years. An examination of the level of antibodies in blood will check the vaccine’s effectiveness.
At times, in case of general illness, anaesthetist may recommend some other checkups or additional consultation with a specialist.
At time of the surgery the patient has to be healthy, with no symptoms of upper respiratory tract infection, i.e. rhinitis, cough etc.
Post-operative care
The surgery itself lasts about half an hour. Afterwards a dressing will have to be worn on an eye until the morning after. For a few weeks after the surgery anti-inflammatory eye drops (Tobradex) will have to be used - 1 drop 3 times a day. If in the morning the eye is festered it is advisable to wash it with boiled lukewarm water or normal saline. The eye may be red and swollen for a few weeks after the surgery. It can also be watery and painful for a few days. You can also feel irritation in the eye because of the stitches around it. Dissolvable stitches are used. They will dissolve within 6 weeks of the surgery and they do not require removal.
For a month after the surgery you must not swim and the eye must be protected from dust. You should also hold off arduous tasks for 2-3 weeks. Usually after 2 weeks you may go back to work or school.
The first control visit, on which the healing process is assessed, takes place 7 days after the surgery. Eye alignment control is conducted 2-3 months after the surgery. It serves to assess long distance effects of the surgery and to plan further procedures.