Recovery of extraocular muscle function after adjustable suture strabismus surgery under local anesthesia

Limited data exist on the recovery of ocular motility after adjustable suture strabismus surgery performed under local anesthesia. The timing of adjustment has been chosen empirically and has varied widely. We sought to more precisely quantify the recovery of motility by measuring ductions before and after surgery with a modified arc perimeter. Twenty-one eyes of 20 patients were studied. All patients underwent adjustable suture strabismus surgery under retrobulbar or peribulbar anesthesia using 2% lidocaine with hyaluronidase. Mean ductions orthogonal to the field of action of the operated muscle(s) returned to 90% of preoperative levels between 5 and 6 hours after injection. We recommend adjustment 6 or more hours after injection, or at least 5 to 6 hours postoperatively, when 2% lidocaine with hyaluronidase is used for local anesthesia.