The authors evaluated the incidence of oculocardiac reflex (OCR) during strabismus surgery to determine its associated risk factors at a tertiary referral centre. Seventy-six patients were reviewed; 51.3% male and a mean age of 15±12 years. Strabismus surgery was bilateral in 68.4%. Right eye surgery was undertaken in 53.9%; 46.09% left eye surgery. Infantile esotropia was present for 81.57%; the remainder being acquired sensory strabismus, reoperations and acquired non-sensory strabismus. A total of 183 muscles of 128 eyes of 76 patients were operated; 143 weakening procedures and 30 strengthening. Medial rectus was operated in 42.8%, lateral rectus in 33.5%, 22% inferior oblique, 1.2% superior oblique and 0.5% superior rectus muscle. Preoperatively, the mean heart rate was 94±25 beats reducing to 77±26 at extraocular muscle hook. Bradycardia was noted in 85.5% of patients and 48.6% of extraocular muscles. This was greater with muscle weakening and on cyclovertical muscles. A risk for OCR was younger subjects, strabismus surgery on cyclovertical muscles and those with higher baseline heart rate.

Oculocardiac reflex during strabismus surgery: experience from a tertiary hospital.
Aletaha M, Bagheri A, Roodneshin F, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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