Strabismus Surgery Risks for Diabetic Patients

Q: Strabismus Surgery Risks for Diabetic Patients

Hello, Miss： "General anesthesia" is achieved through intravenous (or intramuscular) administration of anesthetic agents and inhalation of anesthetic gases to induce a state of analgesia and unconsciousness in surgical patients, facilitating the surgical procedure. <br>The method

Strabismus surgery

Hello, I would like to ask some questions.
My father has diabetes and hypertension, and he had a mild stroke over three years ago.
He has been diligent with rehabilitation, and now his limbs function normally.
However, his vision remains blurry.
He has seen various ophthalmologists, and they all indicated that it is related to his thyroid condition.
At Taichung Veterans General Hospital, they also mentioned that he has mild strabismus and suggested surgery to improve his vision.
However, the consent form states that general anesthesia will be used, and I have heard that general anesthesia carries significant risks.
Given my father's diabetes, hypertension, and history of mild stroke, I am concerned that the risks may be even greater.
Is it possible to use local or regional anesthesia instead? What are the potential side effects? Additionally, my father underwent general anesthesia for an endoscopy due to stomach discomfort less than a month before his mild stroke, and I am unsure if there is a connection between the general anesthesia and the stroke.
I look forward to your detailed explanation.
Thank you! P.S.
My father is 65 years old this year.

Gladys, 20~29 year old female. Ask Date: 2006/06/01

Dr. Liu Jingxian reply Ophthalmology

Hello, Miss: "General anesthesia" is achieved through intravenous (or intramuscular) administration of anesthetic agents and inhalation of anesthetic gases to induce a state of analgesia and unconsciousness in surgical patients, facilitating the surgical procedure.
The method of "general anesthesia" falls under the domain of anesthesiologists, who will consider factors such as the patient's overall condition, the duration of the surgery, and other relevant aspects to make a decision.
All forms of anesthesia carry risks; however, under the careful management of an anesthesiologist, the risks (or complications) can be minimized.
Prior to any general anesthesia, patients will undergo routine blood tests, electrocardiograms, and chest radiographs, and a preoperative consultation with an anesthesiology specialist will be conducted to assess the "anesthetic risks" associated with general anesthesia.
If the anesthetic risk is deemed high, further discussions can be held with the attending physician to consider the possibility of performing the surgery under local anesthesia.
Effective communication is essential to create a win-win situation for both the medical team and the patient.
Wishing you good health.
Dr.
Liu Ching-Hsi, Ophthalmology, Taipei City Hospital, Zhongxing Branch, Taiwan e-Learning Academy.

Reply Date: 2006/06/01

More Info

When considering strabismus surgery for a diabetic patient, especially one with a history of hypertension and a previous mild stroke, it is essential to weigh the potential risks and benefits carefully. Strabismus, or misalignment of the eyes, can lead to issues such as double vision and impaired depth perception, which can significantly affect quality of life. However, the decision to proceed with surgery must take into account the patient's overall health status, particularly their diabetes and cardiovascular history.

Risks of Strabismus Surgery in Diabetic Patients
1. Anesthesia Risks: As you mentioned, your father has a history of mild stroke and is currently managing diabetes and hypertension. General anesthesia carries inherent risks, particularly for patients with pre-existing conditions. In diabetic patients, there is a concern about blood sugar control during surgery, which can affect healing and recovery. Additionally, patients with a history of stroke may have an increased risk of complications related to anesthesia, such as respiratory issues or cardiovascular events.

2. Surgical Risks: Strabismus surgery itself is generally considered safe, but like any surgical procedure, it carries risks such as infection, bleeding, and adverse reactions to anesthesia. For diabetic patients, there is also a risk of delayed wound healing and increased susceptibility to infections due to impaired blood flow and immune response.

3. Postoperative Complications: After surgery, patients may experience complications such as persistent double vision, overcorrection or undercorrection of the eye alignment, and the need for additional surgeries. Diabetic patients may also face a higher risk of complications due to their underlying condition.

Alternatives to General Anesthesia
Given your father's medical history and your concerns about general anesthesia, it is worth discussing the possibility of using regional anesthesia (such as a nerve block) or sedation with the surgical team. These alternatives can reduce the risks associated with general anesthesia while still providing adequate pain control during the procedure. However, the feasibility of these options depends on the specific surgical technique and the surgeon's preference.

Postoperative Care and Follow-Up
After strabismus surgery, careful monitoring is crucial, especially for diabetic patients. Blood sugar levels should be closely managed to promote optimal healing. Regular follow-up appointments will be necessary to assess the alignment of the eyes and to monitor for any complications.

Conclusion
In summary, while strabismus surgery can potentially improve your father's vision and quality of life, it is essential to have a thorough discussion with the surgical team regarding the risks associated with anesthesia and the specific surgical procedure. Ensure that all of your father's medical conditions are well-managed before proceeding. It may also be beneficial to seek a second opinion or consult with an anesthesiologist who specializes in high-risk patients to explore the safest anesthesia options available.

Ultimately, the decision should be made collaboratively with the healthcare team, taking into account your father's overall health, the severity of his strabismus, and his personal preferences. Open communication with the medical team will help ensure that all concerns are addressed and that the best possible care plan is developed.

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