Abstract
Purpose To investigate the effects of topical brimonidine 0.15% instillation on conjunctival injection after strabismus surgery in children. Methods We retrospectively analyzed 63 Korean children who underwent strabismus surgery for intermittent exotropia. Patients received topical brimonidine 0.15% after surgery for up to 4 weeks. Conjunctival injection was objectively assessed using a software that automatically scored the region of interest from the image of the bulbar conjunctiva. Conjunctival injection scores were compared with those of the control group who were not prescribed topical brimonidine. Results The mean scores of conjunctival injection after rectus muscle recession and resection were significantly lower in the brimonidine group than the controls at 4 weeks after surgery (P = 0.008 and 0.046, respectively). There was no significant difference in intraocular pressure between the two groups. No adverse effects, such as dry mouth, fatigue/drowsiness, headache, sedation, hypotension, or bradycardia, were reported. Conclusions Administration of topical brimonidine 0.15% after strabismus surgery is efficacious and safe in reducing postoperative conjunctival injection.
Highlights
Various complications may occur after strabismus surgery, including local issues such as conjunctival injection, scar formation, and inclusion cysts; severe problems such as cellulitis and endophthalmitis are rarely seen [1,2,3]
Patients were excluded if they had other possible causes of inflammatory diseases of the anterior segment, including conjunctivitis, keratitis, and uveitis, a history of prior strabismus surgery, simultaneous oblique or vertical muscle surgery, simultaneous vertical transposition surgery, adjustable surgery, use of biodegradable collagen matrix implant, ocular disease other than strabismus, systemic disorders such as congenital anomalies, neurological disorders, and connective tissue disease, or if they did not comply with postoperative anterior segment photographs. is study was approved by the Institutional Review Board (IRB) of the Seoul National University Bundang Hospital
A total of 63 consecutive patients (36 boys and 27 girls) who underwent rectus resection (RR) surgery were included in the study. e mean age was 9.1 ± 1.0 years
Summary
Various complications may occur after strabismus surgery, including local issues such as conjunctival injection, scar formation, and inclusion cysts; severe problems such as cellulitis and endophthalmitis are rarely seen [1,2,3]. Conjunctival injection is by far one of the most common complications after strabismus surgery [2]. Brimonidine tartrate is a selective α2-adrenergic receptor agonist that has been widely used to lower intraocular pressure (IOP) [5, 6]. As brimonidine affects vasoconstriction primarily via the α2-adrenergic receptor, it has been reported that the pre- and postoperative use of topical brimonidine can help reduce bleeding-related problems in ophthalmic surgery [9,10,11]. Brimonidine has relatively lower systemic adverse effects than other vasoconstrictors such as phenylephrine, and the safety of brimonidine has been confirmed in children over 2 years of age [12]
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