Comparison between bupivacaine injection and mini-tenotomy in the management of horizontal small angle strabismus in children.

Autor: Al-Saeed WN; Department of Ophthalmology, Cairo University, Giza., Elhilali HM; Department of Ophthalmology, Cairo University, Giza., Kamal AM; Department of Ophthalmology, Cairo University, Giza., Mohammad RS; Department of Radiology, Cairo University, Giza., Zedan RH; Department of Ophthalmology, Cairo University, Giza.
Jazyk: angličtina
Zdroj: Strabismus [Strabismus] 2023 Sep; Vol. 31 (3), pp. 172-181. Date of Electronic Publication: 2023 Sep 03.
DOI: 10.1080/09273972.2023.2248196
Abstrakt: Purpose: To compare the outcome of bupivacaine (BUP) injection vs mini-tenotomy of extra-ocular muscles in treating small angle horizontal strabismus in children.
Methods: A prospective comparative study that included a total of 40 patients. Twenty patients received 3 ml of 0.75% Bupivacaine (BUP) injection in both medial recti in case of exotropia and in both lateral recti in case of esotropia. MRI orbit was performed before and 30-60 days' post injection of bupivacaine to estimate changes in muscle size. Mini-tenotomy was done in the other 20 patients, performed on both lateral recti in case of exotropia and on both medial recti in case of esotropia.
Results: Mean change of alignment at the end of 6 months in exotropic patients in bupivacaine group was 5.50 ± 4.10 PD and in esotropia patients 4.00 ± 3.38 PD with an average increase in muscle thickness of 0.12 mm ± 0.08 and 0.13 mm ± 0.09 in exotropia and esotropia, respectively. There was an average increase in volume 23 mm 3 ± 17.3 and 17.00 mm 3 ± 9.50 in exotropia and esotropia, respectively, as measured with MRI. The mean change of alignment in mini-tenotomy was 5.33 ± 4.12 PD, 5.75 ± 4.95 PD in exotropia and esotropia, respectively.
Conclusion: Bupivacaine and mini-tenotomy are safe and effective alternative treatment, that improved eye alignment in 65% of patients with small angle horizontal deviation.
Databáze: MEDLINE
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