A Case of Immediate Surgical Repair in Traumatic Isolated Inferior Rectus Muscle Rupture

Bo Ram Lee; Key Hwan Lim

doi:10.3341/jkos.2017.58.2.235

Journal List > J Korean Ophthalmol Soc > v.58(2) > 1010710

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Lee and Lim: A Case of Immediate Surgical Repair in Traumatic Isolated Inferior Rectus Muscle Rupture

Original Article

J Korean Ophthalmol Soc 2017;58(2):235-239.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.2.235

A Case of Immediate Surgical Repair in Traumatic Isolated Inferior Rectus Muscle Rupture

Bo Ram Lee, M.D., Key Hwan Lim, M.D., PhD

Department of Ophthalmology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea

Address reprint requests to Key Hwan Lim, MD, PhD Department of Ophthalmology, Ewha Womans University Mokdong Hospital, #1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea Tel: 82-2-2650-5659, Fax: 82-2-2654-4334 E-mail: Limkh@ewha.ac.kr

Received 18 August 201629 September 2016 Accepted 5 January 2017

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

We report a case of infraduction limitation improvement and orthotropia at primary position in a patient with traumatic isolated inferior rectus muscle rupture after immediate repair surgery of the ruptured muscle.

Case summary

A 47-year-old man came to our emergency department complaining of right eyelid contusion and conjunctival laceration after trauma due to the metal part of a high pressure hose. Right hypertropia of 20 prism diopters was observed at pri-mary gaze and right hypertropia of 30 prism diopters was observed at down gaze. The right eye showed a -4 infraduction limitation. We sutured the distal part of the ruptured inferior rectus muscle with surrounding tissue, including the Tenon’s capsule and the part of the muscle stump, to its original insertion. Orthotropia at primary position and 8-prism-diopters of right hypertropia on down gaze was observed one day after surgery. At 40 days after surgery, the patient had orthotropia at primary position and 4-prism-diopter right hypertropia on down gaze. Infraduction limitation of the right eye improved to -1.

Conclusions

Immediate repair of complete traumatic isolated inferior rectus muscle rupture can correct the limitation of extra-ocular movement and achieve orthotropia at primary position.

Keywords: Inferior rectus muscle rupture, Strabismus surgery, Trauma

References

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Figure 1.

Preoperative clinical findings. Right hypertropia is noted at primary position and down gaze. Right eye reveals marked limitation of depression.

Figure 2.

Postoperative clinical findings at the 1st day after surgery. Improvement of right hypertropia is noted at primary position.

Figure 3.

Postoperative clinical findings at 40 days after surgery. Improvement of infraduction of the right eye and right hypertropia are shown.

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