A CLUSTER OF PATIENTS WITH INFERIOR RECTUS RESTRICTION FOLLOWING LOCAL-ANESTHESIA FOR CATARACT-SURGERY

During a 5-month period, four patients developed contracture of the in ferior rectus muscle following local anesthesia for cataract surgery i n the practice of one ophthalmologist. Two anesthesiologists administe red retrobulbar anesthesia. All patients had persistent vertical diplo pia caused by a large hypotropia of the operated eye. Forced duction t esting revealed marked restriction to elevation of the eye. In two pat ients, MRI demonstrated segmental thickening of the inferior rectus mu scle, just posterior to the globe. All patients had normal thyroid fun ction tests. No patient had a previous history of strabismus. Three of the four have had strabismus surgery consisting of recession of the m arkedly restricted inferior rectus muscle on an adjustable suture. The se three patients have regained fusion and are now asymptomatic.