A Case of Rectus Muscle Transposition With Silicone Band in Strabismus Fixus With High Myopia

Jun Sung Lee;  Hwan-Heo; Sang Woo Park; Yeoung Geol Park

doi:10.3341/jkos.2009.50.7.1128

Journal List > J Korean Ophthalmol Soc > v.50(7) > 1008322

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Hwan-Heo, Park, and Park: A Case of Rectus Muscle Transposition With Silicone Band in Strabismus Fixus With High Myopia

Original Article

J Korean Ophthalmol Soc 2009;50(7):1128-1132.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.7.1128

A Case of Rectus Muscle Transposition With Silicone Band in Strabismus Fixus With High Myopia

Jun Sung Lee, MD,  Hwan-Heo, MD, Sang Woo Park, MD, Yeoung Geol Park, MD

Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea

Address reprint requests to Sang Woo Park, MD Department of Ophthalmology, Chonnam National University Medical School and Hospital #8 Hak-dong, Dong-gu, Gwangju 501-757, Korea Tel: 82-62-220-6743, Fax: 82-62-227-1642, E-mail: exo70@jnu.ac.kr

Received 3 November 2008 Accepted 7 April 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To present a surgical result of rectus muscle transposition with silicone band without suture on the sclera in strabismus fixus with high myopia.

Case summary

A 73-year-old female patient with a 20-year history of bilateral esotropia and hypotropia visited our clinic. The patient's right eye was aphakic because crystalline lens removal was performed 17 years earlier and the left eye was phthisical after retinal detachment, due to high myopia. Ocular movements in both eyes were severely restricted in all directions with the cornea barely visible. Ultrasound examination revealed posterior staphyloma of the retina. The axial length measurement was 32 mm in the right eye, and could not be measured in the left eye. Posterior tenon fixation of the medial rectus and inferior rectus muscle tendon was performed, in addition, fixation of the lateral half of the superior rectus and superior half of the lateral rectus muscle on the silicone band 10 mm posterior to each muscle's scleral insertion as a transposition procedure was performed. At 6 months postoperatively, there was no residual esotropia or hypotropia. The right eye maintained a gaze limitation but improved abduction and supraduction.

Conclusions

In strabismus fixus with high myopia, posterior tenon fixation and muscle transposition with silicone band is an effective method without complication.

Keywords: High myopia, Silicone band, Strabismus fixus

References

1. Krzizok TH, Kaufmann H, Traupe H. New approach in strabismus surgery in high myopia. Br J Ophthalmol. 1997; 81:625–30.

2. Hayashi T, Iwashige H, Maruo T. Clinical features and surgery for acquired progressive esotropia associated with severe myopia. Acta Ophthalmol Scand. 1999; 77:66–71.

3. Aoki Y, Nishida Y, Hayashi O, et al. Magnetic resonance imaging measurements of extraocularmuscle path shift and posterior eyeball prolapse from the muscle cone in acquired esotropia with high myopia. Am J Ophthalmol. 2003; 136:482–9.

4. Krzizok TH, Schroeder BU. Measurement of recti eye muscle paths by magnetic resonance imaging in highly myopic and normal subjects. Invest Ophthalmol Vis Sci. 1999; 40:2554–60.

5. Weir CR, Cleary M, Stewart H. Progressive esotropia and restricted extraocular movements associated with low myopia. Strabismus. 2007; 15:111–2.

6. Venkatesh CP, Gayathri N, Murthy KR. Myopic strabismus fixus: a mitochondrial myopathy? Am J Ophthalmol. 2003; 135:720–2.

7. Bagolini B, Tamburrelli C, Dickmann A, Colosimo C. Convergent strabismus fixus in high myopic patients. Doc Ophthalmol. 1990; 74:309–20.

8. Wong I, Leo SW, Khoo BK. Loop myopexy for treatment of myopic strabismus fixus. J AAPOS. 2005; 9:589–91.

9. Bagshaw J. Heavy eye phenomenon. A preliminary report. Br Orthopt J. 1966; 23:75–8.

10. Bagolini B, Tamberreli C, Dickmann A, Colosimo C. Convergence strabismus fixus in high myopic patients. Doc Ophthalmol. 1990; 74:309–20.

11. Demer JL, Von Noorden GK. High myopia as an unusual cause of restrictive motility disturbance. Surv Ophthalmol. 1989; 33:281–4.

12. Sharma P, Gupta NK, Arora R, Prakash P. Strabismus fixus convergens secondary to amyloidosis. J Pediatr Ophthalmol Strabismus. 1991; 28:236–7.

13. Bagheri A, Adhami F, Repka MX. Bilateral recession-resection surgery for convergent strabismus fixus associated with high myopia. Strabismus. 2001; 9:225–30.

14. Larsen PC, Gole GA. Partial Jensen's procedure for the treatment of myopic strabismus fixus. J AAPOS. 2004; 8:393–5.

15. Rowe FJ, Noonan CP. Surgical treatment for progressive esotropia in the setting of high-axial myopia. J AAPOS. 2006; 10:596–7.

16. Godeiro KD, Kirsch D, Tabuse MK, Cronemberger M. Yamada's surgery for treatment of myopic strabismus fixus. Int Ophthalmol. 2008; 21:[Epub ahead of print].

17. Heo H, Park SW. Rectus muscle posterior tenon fixation as an inactivation procedure. Am J Ophthalmol. 2008; 146:310–7.

Figure 1.

(A) Preoperative photograph shows both eyes fixed in a position of extreme adduction and infraduction in 73-year-old female patient. (B) Postoperative three-month photograph shows straight alignment in primary position and improved abduction and supraduction in the right eye.

Figure 2.

Intraoperative findings demonstrate (A) the path of the lateral rectus (arrow) muscle was dislocated into the inferotemporal quadrant of the globe and the superior rectus muscle (arrow head) was dislocated into the superonasal quadrant of the globe, caused by the scleral distension. (B) The edge of silicone band (arrow) sutured to the lateral part of the superior rectus (SR) and the superior part of the lateral rectus (LR) muscles is shown, and the silicone band is not sutured onto the sclera.

TOOLS

Similar articles