Review of efficacy and safety of tetracaine drops in strabismus surgery
Reviewed by Fiona Rowe

Tetracaine is a topical anaesthetic drug used to anesthetise the eye and surrounding areas during strabismus surgery. It is generally safe and well tolerated but can cause mild adverse reactions at the site of use and, in rare cases, serious allergic reactions or systemic toxicity. This review aimed to evaluate the safety and efficacy of tetracaine eye drops as an anaesthetic agent in strabismus surgery. The search process identified 114 records of which nine were eligible for full text review and six foe meta-analysis. Six papers included a total of 326 patients; five were tetracaine vs. placebo, and one was tetracaine vs. nothing. In all, tetracaine was used within general anaesthetic. There was no significant difference in groups for mean operating time, mean time to first anaesthetic, mean behaviour score, postop vomiting, or number of additional analgesics. The results of meta-analysis suggest tetracaine eye drops do not provide significant benefits for several outcomes related to strabismus surgery. This has potential implications for practice in that tetracaine may not be the best local anaesthetic for strabismus surgery and it is important to tailor the right local anaesthetic for strabismus surgery according to individual patient needs. Recommendations for future research and for clinical practice are the need for large trials to evaluate safety and efficacy of tetracaine eye drops in strabismus surgery whilst considering optimal concentration and dosage.

Efficacy of tetracaine eye drops in strabismus surgery: a systematic review and meta-analysis of randomised controlled trials.
Almekhyal N, Alotaibi S, Alenezi Z, et al.
STRABISMUS
2023;31(3):210–9.