Bilateral medial rectus aplasia and a modified surgical approach of transposition myopexy of vertical recti

Sharma, Pradeep; Chaurasia, Shweta; Rasal, Abhijit

doi:10.1136/bcr-2017-220404

Cited by 7 publications

(2 citation statements)

References 7 publications

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“…However, none of our patients reported any history of these events. In all five cases, the palsy was monocular and sporadic, which differs from the few cases with dysplasia or absence of isolated extraocular muscles that are binocular and familial [15][16][17] . Due to the early onset of strabismus and amblyopia, none of our cases showed abnormal head positions, nor did they experience diplopia.…”

Section: Congenital Dysplasia In Medial and Inferior Rectimentioning

confidence: 60%

Congenital dysplasia involving both medial and inferior recti: clinical features and surgical outcomes

Zhu

Yan

2021

Int J Ophthalmol

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AIM: To investigate the clinical features and surgical outcomes of congenital dysplasia involving both inferior recti (IR) and medial recti (MR) muscles. METHODS: A retrospective review was conducted including cases of simultaneous congenital dysplasia of IR and MR that were diagnosed and surgically treated at the Zhongshan Ophthalmic Center, Sun Yat-sen University, China, from July 2009 to November 2019. Ocular motility, ocular alignment at distance (6 m) and near (33 cm) by prism alternating cover test and stereoacuity were assessed in all patients before and after surgery. RESULTS: A total of five patients (four males and one female; three with right eye and two with left eye congenital dysplasia) were included in this review. The patients ranged in age from 10 to 42y (21±13.4y). The main clinical findings were hypertropia and exotropia of the affected eye, along with motility limitations in adduction and depression. Lateral rectus (LR) recession/transposition combined with IR resection was performed in one case. Two scheduled surgeries were performed in four cases, with one involving superior rectus recession and IR resection and the others LR recession and MR resection. Mean±SD pre-surgical exotropia of 51.0±31.11 prism diopter (PD) and hypertropia of 29.20±7.12 PD in the primary position were decreased to 3.6±12.90 and 3.2±10.09 PD, respectively, at two years after surgery, with a success rate of 60% and an under-correction rate of 40%. CONCLUSION: The main clinical features associated with simultaneous MR/IR congenital dysplasia are hypertropia and exotropia of the affected eye along with motility limitations in adduction and depression. Scheduled two-stage surgeries achieved a success rate of 60%.

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Section: Congenital Dysplasia In Medial and Inferior Rectimentioning

confidence: 60%

Congenital dysplasia involving both medial and inferior recti: clinical features and surgical outcomes

Zhu

Yan

2021

Int J Ophthalmol

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“…In our patient, we also found thin MR on MRI, but intraoperatively, the muscle was absent on both sides. The discrepancy of imaging and the intraoperative finding could be due to separate development of global and orbital muscle fibres and the absence of global fibres 20 21. This agenesis occurs because an abnormal mutual stimulus between the orbital bones and the extraocular muscles arrests the growth of the specific muscle fibres.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative absent bilateral medial recti in syndromic craniosynostosis

et al. 2021

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Patients with syndromic craniosynostosis are usually associated with the complexity of the malformation complex. We describe here detailed oculo-motility disorder and a remarkable finding of hypoplastic bilateral media recti on imaging and its intraoperative absence in patients with phenotypic features resembling Shprintzen-Goldberg syndrome (SGS). SGS is a rare congenital disorder with craniosynostosis affecting multiple systems including mentation and having a considerable overlap of its phenotypic features with Marfan syndrome. Large A-pattern exotropia found in these patients may be related to the craniofacial features and their bearing on extraocular muscle development and function. In this paper, we aimed to sensitise ophthalmologists and strabismologists concerning the necessity to recognise syndromic associations of patients with craniosynostosis presenting with a large squint, be aware of the intraoperative surprises and consider the challenges in its management.

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Minimal invasive vertical muscle transposition for the treatment of large angle exotropia due to congenital medial rectus hypoplasia: Case Report and Literature Review

et al. 2020

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Bilateral medial rectus aplasia and a modified surgical approach of transposition myopexy of vertical recti

Cited by 7 publications

References 7 publications

Congenital dysplasia involving both medial and inferior recti: clinical features and surgical outcomes

Congenital dysplasia involving both medial and inferior recti: clinical features and surgical outcomes

Intraoperative absent bilateral medial recti in syndromic craniosynostosis

Minimal invasive vertical muscle transposition for the treatment of large angle exotropia due to congenital medial rectus hypoplasia: Case Report and Literature Review

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