Change of Eye Position in Patients with Orthophoria and Horizontal Strabismus under General Anesthesia

We studied the relationship between eye position in the awakened state and in the surgical plane of anesthesia in orthophoric and horizontal strabismus patients. We classified 105 orthophoric and horizontal strabismus patients into 5 groups, measured the eye position at the primary position by photographic measurement of the corneal reflex positions and undertook a quantitative study of eye position. Under general anesthesia, the mean divergence was 39.7±8 PD for the esotropia group, 36.6 ±11.7 PD for exophoria, 27.4±8.1 PD for orthophoria, and 11.1±10.2 PD for exotropia I (≤30 PD). Therefore, the esotropia group had the largest amount of divergence among the groups, but the eye position of the exotropia II (>30 PD) group was rather convergent at 11.0±6.5 PD. According to the eye position of the fixating and nonfixating eyes in the esotropia group, both eyes converged with an angle deviation of 14.4±4.8 PD divergent and 14.1±4.8 PD divergent, respectively (P=.71). In the exotropia groups (I, II), the fixating eye diverged but the nonfixating eye rather converged. Therefore, the angle deviation was 19.0±2.1 PD divergent for the fixating eye and 18.2±6.4 PD divergent for the nonfixating eye (P=.68). In conclusion, under general anesthesia, eye positions in the awakened state and in the surgical plane of anesthesia were convergent or divergent, and showed a tendency to converge into the position of 25-35 PD divergent. Therefore, we could not distinguish fixating eye from nonfixating eye under general anesthesia.