Change in the eye position under general anesthesia in children with intermittent exotropia

Abstract

Purpose: To evaluate the eye position in subjects with intermittent exotropia and normal subjects under general anesthesia (GA) using the strabismus photo analyzer. Methods: This retrospective case–control study included 78 subjects with intermittent exotropia and 25 normal control subjects who underwent epiblepharon surgery. Eye position under GA was assessed using the strabismus photo analyzer, based on eye models generated from corneal lights and limbus in pre- and post-anesthesia images. Eye positions under GA in the control and intermittent exotropia groups were compared. Preoperative angle of deviation was also compared with amount of change in eye position under GA in the intermittent exotropia group. Results: Eye position under GA was more divergent in subjects with intermittent exotropia than in controls (P = 0.008). The amount of change in eye position under GA was correlated with the preoperative angle of deviation (r2 = 0.47; P < 0.001). In small preoperative exodeviations, the change in eye position was primarily more divergent, whereas in large exodeviations, a convergent tendency—less exotropic compared with the preoperative angle of exodeviation—was observed. Conclusions: In subjects with small preoperative exodeviations, there was a tendency for eye position to become more divergent after GA; in those with large exodeviations, there was less exotropia after GA. © 2021 American Association for Pediatric Ophthalmology and Strabismus