Combined recession surgery with Bupivacaine injection
Reviewed by Fiona Rowe

The aim of this study was to evaluate the amount of correction of sensory strabismus with Bupivacaine injection combined with antagonist muscle recession. This was a prospective study of nine patients aged 43.5 ±12.3 years; six males and three females. Five had exotropia with a mean preoperative angle of 50 ±6.12PD, mean correction of 23 ±14.4PD, mean lateral rectus recession of nine ±0mm and dose-response of 2.6PD/mm. Four had esotropia with a mean preoperative angle of 28.7 ±14.9PD, mean correction of 21.25 ±4.8PD, mean medial rectus recession of 4.25 ±2.2mm and dose-response of 5 PD/mm. At 180-day follow-up, 44% had successful correction. Of the remaining five patients, four were exotropic with deviation >45PD. No side effects were reported. This was a pilot study indicating the procedure may be useful for small angle deviations <25PD. However, further studies are needed to evaluate different doses in larger angles.

Bupivacaine injection combined with recession of antagonist rectus muscle to treat sensory strabismus.
Hopker LM, Modelli R, Allemann N.
STRABISMUS
2019;27(1):6-10.