TIVA with propofol/remifentanil proved to be a suitable form of anaesthesia for children in this setting. Propofol showed advantages over sevoflurane/N2O with respect to PONV after squint surgery in children also when applied in the combination with remifentanil. TIVA with propofol/remifentanil may therefore be one way to reduce the high incidence of PONV in this setting, bearing in mind, that PONV is not only influenced by the regimen of the general anaesthesia but rather by the combination of many other factors, in particular the type of operation.

Exotropia appearing immediately after surgery is most likely the result of an individually overdosed operation. This conclusion is not sufficient for delayed exotropia. Motor and sensory instabilities, such as those in patients needing a faden operation with simultaneous shortening of the anterior muscle segment for the treatment of convergence excess with no deviation at far or in patients showing cerebral palsy, seem to increase the risk of delayed consecutive exotropia. The mean interval between the initial surgery and the manifestation of consecutive exotropia is lower than is known from other surgical procedures.

In cases of difficult or inaccurate preoperative ultrasound biometry IOL power can be estimated after intraoperative retinoscopy in the aphacic highly myopic eye. IOL power can be calculated instantly using computer programs or tables. This method additionally enables the surgeon to control the refractive result of intraocular lens implantation prior to wound closure. However this method lacks reliability in higher hyperopic eyes, as in these cases small changes in corneal vertex distance of the lens used for retinoscopy highly alter the result.

Between 1984 and 1989, 79 patients were reexamined an average of 8 years after bimedial rectus muscle posterior fixation sutures. Patients who had to be operated additionally for vertical or cyclovertical motility disorders were excluded from the study. Seventy-five percent of the patients showed a residual deviation in the alternating prism and cover test of up to 5°. With Bagolini striated glasses 60 patients were found to have simultaneous perception at near and distance. The effects on convergence and lateral gaze were examined. After completed surgical therapy consecutive exotropia was found in 5% of all cases. In every 5th patient a reoperation was required. The study shows that bilateral posterior fixation suture of the medial rectus muscles leads to good long-term results in correcting infantile esotropia. Compared to other surgical techniques, significant advantage results from the low number of consecutive exotropias.

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