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.

scholarly journals Early Results of Slanted Recession of the Lateral Rectus Muscle for Intermittent Exotropia with Convergence Insufficiency

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Bo Young Chun ◽  
Kyung Min Kang
Keyword(s):  
Rectus Muscle ◽  
Lateral Rectus ◽  
Mean Deviation ◽  
Intermittent Exotropia ◽  
Convergence Insufficiency ◽  
Lateral Rectus Muscle ◽  
Early Results ◽  
Distance Difference ◽  
The Mean

The aim of this study was to evaluate the efficacy of slanted recession of the lateral rectus muscle for intermittent exotropia with convergence insufficiency. This prospective study included 31 patients who underwent slanted lateral rectus recession for intermittent exotropia with convergence insufficiency between June 2010 and June 2012. Following parameters were recorded and analyzed: patient sex, age, preoperative and postoperative near and distance ocular alignment, and changes in stereopsis. The mean age of the patients was 9.2 years. The preoperative mean deviation angle was 32.4 PD at distance and 43.4 PD at near. After 6 months, slanted lateral rectus recession reduced the deviation angles to 2 PD at distance and 3.4 PD at near. In addition, the mean difference between distance and near deviation angles was significantly reduced from 11 PD to 1.4 PD at 6 months postoperatively. Slanted lateral rectus recession for intermittent exotropia with convergence insufficiency in children successfully reduced the distance and near exodeviations and the near-distance difference without increasing the risk of long-term postoperative esotropia or diplopia.

scholarly journals Augmented Lateral Rectus Muscle Recession for treatment of Infantile Exotropia

2021 ◽  
Author(s):  
Lijuan Huang ◽  
Ningdong Li
Keyword(s):  
Binocular Vision ◽  
Large Deviation ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Oblique Muscle ◽  
Final Visit ◽  
Ocular Motility ◽  
Inferior Oblique Muscle ◽  
Lateral Rectus Muscle ◽  
The Mean

Abstract Background: For the majority of the patients, surgical treatment of primary infantile exotropia (PIE) with large exodeviation angels of more than 50 prism diopters (PD) is not satisfactory. We evaluate the effectiveness of augmented lateral rectus (LR) muscle recession in treatment of congenital exotropia with large deviation angles. Methods: A retrospective analysis was performed for 25 patients with congenital exotropia who had at least 60 prism diopters (PD). Augmented LR recession was performed using a hemi hang-back technique. The ocular alignment, ocular motility and binocular vision were evaluated pre- and postoperatively. Results: There were 14 male and 11 female affected individuals with congenital exotropia included in this study, with a mean age of (3.92±2.02) years (range, 1 - 7 years). The average exodeviation angle was (68.0±8.78) PD (range, 60 - 80 PD) preoperatively. All patients underwent bilateral LR recession, of whom 3 patients underwent bilateral inferior oblique muscle transposition in the same operation. The mean surgical dosage was (11.08±1.19) mm for each lateral rectus muclse. All patients did not have abduction deficiency after a large amount of lateral rectus recession. 21 of 25 patients (84.0%) acquired orthophoria at the primary gaze position at the final visit. 13 patients obtained binocular vision. Conclusions: Augmented bilateral LR recession is an effective and safe surgical procedure for treatment of congenital exotropia with large deviation angles.

scholarly journals Lateral rectus muscle differentiation potential in paralytic esotropia patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Xia ◽  
Xiangtian Ling ◽  
Zhonghao Wang ◽  
Tao Shen ◽  
Minghao Chen ◽  
...  
Keyword(s):  
Gene Expression ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Control Group ◽  
Differentiation Potential ◽  
Partial Restoration ◽  
Reverse Transcription Pcr ◽  
Lateral Rectus Muscle

Abstract Purpose and background Recently, we found that maximal medial rectus recession and lateral rectus resection in patients with complete lateral rectus paralysis resulted in a partial restoration of abduction. In an attempt to understand some of the mechanisms involved with this effect we examined gene expression profiles of lateral recti from these patients, with our focus being directed to genes related to myogenesis. Materials and methods Lateral recti resected from patients with complete lateral rectus paralysis and those from concomitant esotropia (controls) were collected. Differences in gene expression profiles between these two groups were examined using microarray analysis and quantitative Reverse-transcription PCR (qRT-PCR). Results A total of 3056 differentially expressed genes (DEGs) were identified between these two groups. Within the paralytic esotropia group, 2081 genes were up-regulated and 975 down-regulated. The results of RT-PCR revealed that PAX7, MYOG, PITX1, SIX1 and SIX4 showed higher levels of expression, while that of MYOD a lower level of expression within the paralytic esotropia group as compared with that in the control group (p < 0.05). Conclusion The decreased expression of MYOD in the paralytic esotropia group suggested that extraocular muscle satellite cell (EOMSCs) differentiation processes were inhibited. Whereas the high expression levels of PAX7, SIX1/4 and MYOG, suggested that the EOMSCs were showing an effective potential for differentiation. The stimulation resulting from muscle surgery may induce EOMSCs to differentiate and thus restore abduction function.

Behavior of cat abducens motoneurons following the injection of toxic ricin into the lateral rectus muscle

1991 ◽  
Vol 544 (2) ◽  
pp. 260-268 ◽  
Author(s):  
R.R. de la Cruz ◽  
R. Baker ◽  
J.M. Delgado-García
Keyword(s):  
Rectus Muscle ◽  
Lateral Rectus ◽  
Lateral Rectus Muscle
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