Anesthetic myotoxicity as a cause of restrictive strabismus after scleral buckling surgery

Purpose: To explore the possibility that anesthetic myotoxicity may play a role in restrictive strabismus following scleral buckling procedures. Methods: The authors performed a retrospective study of patients who presen ted with strabismus following scleral buckling procedures. Details were sou ght regarding the scleral buckling procedure, including type and route of a nesthesia, The types of strabismus were compiled, as were relevant findings at strabismus surgery, The contributing vitreoretinal surgeons were survey ed regarding the usual type and route of anesthesia used for their scleral buckling procedures. Results: Over 90% of scleral buckling procedures resulting in significant s trabismus were performed under local anesthesia. Of the 17 patients on whom strabismus surgery was performed, 14 had positive forced ductions, A hypod eviation of the buckled eye was the most common presentation. Conclusion: Based on the types, patterns, and amounts of strabismus encount ered after scleral buckling procedures, and the similarity of these finding s to cases of strabismus following retrobulbar anesthesia for cataract proc edures, the authors propose that local anesthetic myotoxicity is often the primary cause of strabismus occurring after scleral buckling procedures for retinal detachment.