title: Bupivacaine injection to treat exotropia and esotropia.
abstract: OBJECTIVE
  To report the results of bupivacaine injection into the extraocular muscles to treat horizontal strabismus, both exotropia and esotropia.
  
  
  METHODS
  Bupivacaine, 4.5 ml of a 0.50% solution, was injected into the medial rectus muscle in each of 14 exotropic patients and into the lateral rectus muscle in each of 6 esotropic patients with electromyographic control. The measures of alignment were made before the procedure and 1, 3, 6, and 12 months after injection.
  
  
  RESULTS
  Of 20 patients, 15 had improved ocular alignment with the average change of 8.46, 8.2, 8.33 and 9 prism diopters (PD) at 1,3, 6 and 12 months, respectively. Two of 5 (40%) incomitant strabismus patients and 13 of 15 (86.66%) comitant strabismus patients had improvement in ocular alignment. Eleven of 14 exotropic patient and 4 of 6 esotropic patients had improvement in ocular alignment, averaging 9.73, 9.36, 9.54 and 6 PD in the exotropic group and 5, 5, 5, and 10.5 PD in the esotropic group. There was no serious complication from the injections.
  
  
  CONCLUSIONS
  Bupivacaine injection improved ocular alignment in some patients. Denervated extraocular muscle did not respond well to bupivacaine. Bupivacaine improved ocular alignment equally in esotropic and exotropic patients.
authors.affiliation: Department of Ophthalmology, Priest Hospital, Thailand. sorotw@gmail.com
authors.forename: Sorot
authors.initials: S
authors.lastname: Wutthiphan
authors.forename: Sombat
authors.initials: S
authors.lastname: Srisuwanporn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002045:Bupivacaine / Q000008:administration & dosage*; D003228:Conjunctiva / Q000098:blood supply; D004948:Esotropia / Q000188:drug therapy*; D005099:Exotropia / Q000188:drug therapy*; D005130:Eye Hemorrhage / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles
chemical_list: D002045:Bupivacaine