Bupivacaine Injection without Electromyographic Guide for Correction of Residual Esotropia and Exotropia after Strabismus Surgery.

Purpose: 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 distance and 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 months far alignment change (ρ = 0.39, p = .04), 6 months near alignment change (ρ = 0.41, p = .03), and 12 months near alignment change (ρ = 0.69, p = .01).

Conclusion

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