ArticleClinical ophthalmology (Auckland, N.Z.)2026
Oculocardiac Reflex During Strabismus Surgery: Conjunctival Incision versus Standardized Rectus Muscle Traction.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04353960 (The Alaska Oculocardiac Reflex Study), which is not on this map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Alaska Oculocardiac Reflex Study
Who cites it
1 citing paper in PubMed.
- Effect of Sub-Anesthetic Dose Esketamine on Oculocardiac Reflex in Children Undergoing Day-Case Strabismus Surgery: A Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Extraocular muscle (EOM) tension during strabismus surgery produces trigemino-vagal bradycardia as a form of the oculocardiac reflex (OCR). Surface pain in the eye can cause bradycardia in premature infant eye examinations, so we evaluated the effect on the heart rate of different aspects of strabismus surgery. Methods: Electrocardiograph heart rate (H.R.) was monitored during outpatient strabismus surgery without anticholinergic or local anesthetic. The impact of limbus-based conjunctival incision was compared to 200 gram, 10-second tension on rectus muscles. Results: The 239 patients aged 0.6 to 83 years (16±20) during the limbal conjunctival incision had median change in H.R. from 100 bpm to 103 bpm, while initial rectus tension changed from 102 bpm to 75 bpm. Compared to median (and interquartile range) %HR with incision of 100% (100%, 101%) the corresponding first rectus tension 82% (65%, 98%) and subsequent rectus tension 80% (65%, 92%) were significantly greater (Kruskal-Wallis X2(2) = 251, p < 0.001) independent of gender, race, iris color, neurologic deficit, use of fentanyl or dexmedetomidine. Younger patients had greater percent heart rate drop with muscle tension but not conjunctival incision. Conclusion: Despite uninhibited pain receptors and general anesthesia in children and adults, conjunctival incision produced essentially no OCR compared to EOM rectus tension. Clinical Trials Registry: Clinical trial registration NCT04353960. Data Access: https://www.abcd-vision.org/references/OCR%20Incision%202025.pdf.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.