Bupivacaine injection without electromyographic guide for correction of residual esotropia and exotropia after strabismus surgery

Arash Mir Mohammad Sadeghi1 *, Mohammad Reza Akbari1 , Fereydun Sajadi1 , Asghar Mollazadeh Jelodar1

  1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abstract: To evaluate the effect of bupivacaine injection without electromyographic guide for correcting residual esotropia and exotropia after strabismus surgery.

Methods: Thirty patients with residual esotropia or exotropia after strabismus surgery were included in the study. Three milliliters of bupivacaine 0.5% were injected into medial or lateral rectus muscle without electromyographic guide.

Results: The mean pre-injection misalignments were 14.8±3.4 (8-20) PD at distance and 14.7±4.4 (6-25) PD at near. The 1 month post-injection alignment changes were 5.2±2.6 (2-13) PD at distanceand 6.5±3.1 (2-18) PD at near. The 6 months post-injection alignment changes were 5.8±2.6 (2-13) PD at distance and 7.0±3.6 (2-18) PD at near. LogMAR of the worst eye had strong correlations with 6 month far alignment change (ρ=0.39, p=0.04), 6 month near alignment change (ρ=0.41, p=0.03), and 12 month near alignment change (ρ=0.69, p=0.01).

Conclusion: The effect of bupivacaine injection without electromyographic guide for correcting residual esotropia or exotropia after strabismus surgery was between 2-18 PD, comparable with other studies on unoperated cases. The effect of bupivacaine may increase with decreasing visual acuity.





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