scholarly journals Postoperative change in lateral rectus muscle insertion measured by anterior segment optical coherence tomography

Eye ◽  
2017 ◽  
Vol 31 (11) ◽  
pp. 1556-1561 ◽  
Author(s):  
J-Y Lee ◽  
K-A Park ◽  
I J Lyu ◽  
S Y Oh
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Optical Coherence ◽  
Postoperative Change ◽  
Lateral Rectus Muscle ◽  
Muscle Insertion

scholarly journals Pre-, Intra-, and Post-Operative Evaluation of Extraocular Muscle Insertions Using Optical Coherence Tomography: A Comparison of Four Devices

2019 ◽  
Vol 8 (10) ◽  
pp. 1732 ◽  
Author(s):  
Matthew S. Pihlblad ◽  
Andrew Troia ◽  
Sapna Tibrewal ◽  
Parth R. Shah
Keyword(s):  
Optical Coherence Tomography ◽  
Intraclass Correlation ◽  
Anterior Segment ◽  
Correlation Coefficients ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Optical Coherence ◽  
Intraclass Correlation Coefficients ◽  
Muscle Insertion ◽  
Operative Evaluation

OCT (optical coherence tomography) is widely used in ophthalmology and pediatric ophthalmology, but limited research has been done on the use of OCT in strabismus. This study investigates the use of different OCT machines to image rectus muscle insertions pre-, intra-, and post-operatively in pediatric strabismus patients. The OCT machines used in the study were a Bioptigen (Leica Microsystems Inc., Buffalo Grove, IL, USA), Spectralis HRA+OCT with Anterior Segment Module (Heidelberg Engineering, Heidelberg, Germany), Visante (Carl Zeiss, Oberkochen, Germany), and Zeiss Rescan 700 (Carl Zeiss, Oberkochen, Germany). Measurements from the machines were compared with the caliper distance measured during the strabismus surgery before disinsertion or after reattachment. The OCT machines had moderate (Bioptigen: 0.62) to good intraclass correlation coefficients (Rescan: 0.83, Spectralis: 0.85, Visante: 0.88) with intra-operative measurements. To our knowledge, this is the first study to use an operating microscope with integrated intra-operative OCT to image rectus muscle insertions. OCT is a useful tool in strabismus surgical patients in the pre-, intra-, and post-operative settings, particularly in patients who have had previous surgery, when the muscle insertion is unknown. The ability to accurately image rectus muscle insertions has significant implications for the management of strabismus patients.

scholarly journals New Modification of Vertical Muscle Transposition to Enhance Abducting Force in Sixth Nerve Palsy

2021 ◽  
Author(s):  
Santa Heede ◽  
Irina Kovalevskaya ◽  
William Astle ◽  
Sandra Valeina ◽  
Uwe Griebenow
Keyword(s):  
Tangential Force ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Mean Deviation ◽  
Retrospective Case ◽  
Lateral Rectus Muscle ◽  
Abducens Paralysis ◽  
Temporal Parts ◽  
The Mean

Abstract Purpose:Since 1907, multiple transposition procedures have been established for the treatment of abducens paralysis. In this study, we try to determine where the transposed muscle should be reattached in order to increase the tangential force necessary to improve abduction.Methods:Retrospective case review of 12 consecutive patients with abducens paralysis. All patients underwent the transposition procedure between 2016 and 2019.Vertical rectus muscles are transposed to the insertion of lateral rectus muscle: The temporal parts are joined and sutured to the sclera on top of the lateral rectus muscle in the middle of the insertion. The nasal parts are sutured to the sclera following the spiral of Tillaux. The muscle junction suture is placed 8 mm from the insertion: The temporal parts of the vertical muscles bellies are joined and sutured to the lateral rectus muscle. A full tendon transposition was performed on 11 patients, a half tendon transposition procedure on one patient. The minimum follow-up was 3 months.Results:The mean preoperative deviation was ET of 37° (range: ET 24° to ET 51°). The mean preoperative abduction limitation was 5 mm from midline (range: -7 to -1mm). The postoperative mean deviation was ET of 2° PD (range: 0 to ET 5°). The postoperative mean abduction improvement was 5mm past midline (range: +2 to +6mm). There were no complications, or signs of anterior segment ischemia. Conclusions:To achieve the maximal abductive force from the transposed muscles, we suggest that the vertical muscles be reattached as close as possible to the middle of the lateral rectus insertion.

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