Effect of Topical Brimonidine 0.15% on Conjunctival Injection after Strabismus Surgery in Children

Dong Hyun Kim, Hee Kyung Yang, Sang Beom Han, Jeong-Min Hwang, Dong Hyun Kim, Hee Kyung Yang, Sang Beom Han, Jeong-Min Hwang

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.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Copyright © 2021 Dong Hyun Kim et al.

Figures

Figure 1
Figure 1
Anterior segment photographs of conjunctival injection before and after strabismus surgery in the brimonidine group ((a), (b)) and control group ((c), (d)). Conjunctival injection increased after strabismus surgery in both groups, while the amount of increase was less in the brimonidine group. Based on the preoperative conjunctival injection score, (b) scored 6.4 and (d) scored 33.3.
Figure 2
Figure 2
Comparison of conjunctival injection between the brimonidine group and control group. The mean score of injection at the temporal bulbar conjunctiva overlaying an area of the previous lateral rectus recession was significantly lower in the brimonidine group, 9.1 ± 9.9 in the brimonidine group and 15.9 ± 9.8 in the control group (p=0.008). At the nasal bulbar conjunctiva overlaying an area of the previous medial rectus resection, the mean score of conjunctival injection was significantly lower in the brimonidine group, 13.0 ± 11.1 in the brimonidine group and 18.6 ± 10.5 in the control group (p=0.046).

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