Chapter 15: What are the Potential Complications?
A Patient & Parent Guide to Strabismus Surgery
George R. Beauchamp, M.D.
Following eye muscle surgery, what are the potential complications? Unsatisfactory alignment is usually apparent to all parties. Over and under corrections may be apparent to observers, or to the patient. This may be known by observation of the alignment proper, or by symptoms such as double vision. Remember that early postoperative alignment (within the first week following surgery) does not always indicate final alignment. Generally, the results of surgery can be reliably assessed at six to eight weeks following surgery.
In children, double vision is uncommon or quite transient. The child’s brain is able to adapt to the new alignment of the eyes very rapidly. Yet even if double vision does occur, it may be a positive indication! For example, if a child has been suppressing the vision in one eye before surgery, the appreciation of two images may indicate that they are being received simultaneously. One way for such children to resolve the double vision is to fuse, or process the images binocularly; such fusion can be beneficial long term in the development of vision and maintenance of straight eyes.
Infection in strabismus surgery is very uncommon. Three strategies have proven effective in its control. First, careful preparation with sterilizing agents at the time of surgery limits the number of bacteria in the area. Second, some surgeons will routinely use prophylactic antibiotics taken by mouth after the surgery. And third, prompt attention to the possible signs of infection can permit early institution of antibiotic therapy and prevent complications. The signs of infection are usually not subtle! The combination of large amounts of swelling and redness of the lids plus fever and unremitting and worsening pain suggest the possibility of infection. Call you doctor if you are concerned!
Loss of vision
Loss of vision can occur, yet is extremely rare. The usual cause of loss of vision is infection that spreads to the inside of the eye. The coat of the eye is thin, and an aggressive infection can spread along suture tracks. The key to successful treatment is early detection. Please note the signs of infection as above.
Anesthesia related problems
Serious problems with anesthesia are so rare as to be difficult to measure in the population of persons undergoing strabismus surgery. There has been a quiet revolution in anesthetic procedures and safety within the past 20 years. Modern medicines and monitoring techniques, coupled with highly skilled medical personnel, have made a general anesthetic extraordinarily safe. In healthy persons, the risk of serious complications is probably on the order of one in one million. Please be certain to share with your doctors, especially your surgeon and anesthesiologist, all of your current medicines, allergies and medical problems. Make special mention of neurological problems, diseases involving muscles, and any problems with anesthesia family members may have had in the past.
Read about Myths About Strabismus Surgery
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