Histopathological changes in extraocular muscles of rabbits following injection of bupivacaine 5mg/Ml versus 7.5mg/Ml

El-Mofty, Randa Mohamed Abdel-Moneim; Kassem, Rehab R.; Abdel‐Salam, Lubna O.

doi:10.1080/15569527.2022.2066113

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…There are various options in the management of strabismus, and the procedures differ in how they affect the neuromuscular arrangement including Botulinum toxin injection 37 and Bupivacaine. 38 However, it has been suggested that botulinum toxin induce ultrastructural changes in the myotendinous nerve endings and that the toxin temporarily affects proprioceptive feedback from palisade endings. 39,40 The effect of Bupivacaine on extraocular muscle proprioception remains unclear and further animal studies are required.…”

Section: Discussionmentioning

confidence: 99%

Does Surgical Resection of Horizontal Extraocular Muscles Disrupt Ocular Proprioceptors?

Paduca¹,

Lundmark²,

Bruenech³

2023

OPTH

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It has been promoted that disturbance of ocular proprioception may play a role in the pathogenesis of concomitant strabismus and other types of oculomotor anomalies. The aim of the study was to obtain knowledge about how surgical foreshortening of the myotendinous region potentially affects the proprioceptors that resides in this area of the muscles and to test the hypothesis that avoiding disruption of ocular proprioceptors result in a more favorable long term postoperative result. Patients and Methods: The distal end of the lateral and medial rectus muscles from patients with manifest concomitant strabismus with a deviation of ≥15 prism diopters (PD) were collected during strabismus surgery and processed for light microscopy by standard histochemical techniques. Histological analysis served to differentiate between the tissue samples containing pure tendon, versus samples containing the myotendinous junction. Criteria for successful outcome was defined as a residual angle of deviation less than 10 PD. The binocular status of the patient was measured pre-and post-operatively at 6-months of follow-up. Results: Tissue samples from 43 patients (median age 19 years old, range 3-58 years) were collected during surgery. Twenty-six of the samples contained pure tendon, while 17 contained muscle fibres. The evolution of the post-operative result revealed a moderate reduction in the residual angle of deviation in patient-samples containing pure tendon. In contrast, the residual angle of deviation clearly increased in patient-samples containing muscle fibres. The difference between the two groups reached statistical significance after 6 months. Successful outcome was found to be more than three times more likely in cases where surgery was performed in pure tendon, compared to muscle fibres. Conclusion:The current study supports the hypothesis that avoiding disruption of ocular proprioceptors, located in the distal myotendinous region, results in a more favorable postoperative result.

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