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Intramuscular bupivacaine injections found to correct strabismus
Researchers found that bupivacaine injected into the extraocular muscles of patients with comitant horizontal strabismus improved ocular alignment.
Miller and colleagues reported in Ophthalmology that they studied 31 patients with comitant horizontal strabismus for up to 3 years.
Of the participants, 19 with esotropia received bupivacaine injections in their lateral rectus muscle and 12 with exotropia received the injection in their medial rectus, according to the study. Sixteen patients with large strabismus angles were also given botulinum type A toxin injections in the antagonist muscle. Thirteen patients who experienced residual strabismus after the first treatment were given second treatments.
Results showed that the bupivacaine injection, with or without the addition of the botulinum injection, was effective in improving eye alignment in patients with comitant horizontal strabismus. With computer modeling, researchers also found that lasting changes in eye alignment were likely due to changes in agonist and antagonist muscle lengths.
"Bupivacaine injection is a useful treatment for nonparalytic strabismus where surgery is contraindicated," the authors concluded. "Ongoing refinements are expected to increase its effectiveness and broaden its applications."
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Ophthalmol. 2013;doi: 10.1016/j.ophtha.2013.06.003.