Background: The natural evolution toward emmetropia is governed by genetic factors, but experiments with animals have demonstrated that a feedback mechanism that depends on visual function may regulate ocular growth. We attempted to verify this hypothesis in school-age patients with amblyopia by observing the ocular growth and the refractive state in the fixating and nonfixating eye in myopia and hypermetropia. This situation simulates the animal model. Methods: In 30 consecutive school-age patients with amblyopia, we prospectively evaluated axial length with echobiometry and the refractive state during cycloplegia induced by atropine. Results: We found a statistically significant increase in axial length in the fixating eye of patients with hypermetropia compared with the amblyopic eye (P = .0008). In patients with myopia, we found less of an increase in axial length in the fixating eye compared with the amblyopic eye (P = .0048). Conclusion: Good vision seems to influence the evolution of ocular growth toward emmetropization. Journal of Pediatric Ophthalmology and Strabismus 2002;39:209-214.

Purpose: To evaluate the efficacy and safety of peribulbar anesthesia during strabismus surgery. Methods: Medical records of patients undergoing strabismus surgery and peribulbar anesthesia were reviewed. The overall efficacy of peribulbar anesthesia was evaluated as requirement of supplemental peribulbar anesthesia, impossibility to perform eye muscles surgery due to inadequate efficacy of the block and peribulbar block complications that occurred up to 6 weeks postoperatively. Presence of oculocardiac reflex (OCR) and presence of decreased visual acuity and afferent pupillary defect postoperatively were reported. Results: A total of 510 patients comprised our study group. The total amount of peribulbar injections was 717. Four patients (0.7%) required supplemental injection in the superonasal quadrant. Five of 510 (0.9%) required an anesthesiologic intervention with intravenous atropine. Eighty patients of 510 (15.6%) complained about transitory complete ptosis and/or amaurosis postoperatively. No complications were observed up to 6 weeks postoperatively. Conclusion: Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients.

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We report our results in nystagmus without null point surgery, utilizing a new technique consisting in the placement of a silicone encircling band around the globe over the four recti muscles, in the retroequatorial position. This method was tried only in nystagmus without null point and with both horizontal and vertical movements. We have not observed any ischemic complication of the anterior segment nor any important variation of intraocular pressure probably because the silicone band was not tightened. Other advantages of this method are its reversibility (cutting the silicone band) and the possibility of combining it with recession-resection of recti muscles at the same or at a later date.

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