Medial and Lateral Rectus Muscle Insertion Distance and Width in Esotropia and Exotropia Patients

Niyaz, Leyla; Yücel, Özlem Eşki; Gül, Adem

doi:10.1080/02713683.2017.1313429

Cited by 5 publications

(16 citation statements)

References 5 publications

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“…The muscle insertion and its anatomy are important for understanding the physiology of eye movements. However, available anatomic studies on insertions of extraocular muscles especially in vivo measurements are very few [5, 6] and no study on AACE has focused on anatomic characteristics of extraocular muscles. Among all the extraocular muscles, Lai et al [5] found the insertion of the medial rectus seemed to be the most reliable and invariant of the rectus muscles in all patients regardless of their ethnic background.…”

Section: Discussionmentioning

confidence: 99%

“…Athavale et al [18] and Surawatsatien et al [19] found the distance of insertion of medial rectus to the limbus was 7.3 mm in Indian population and 5.7 mm in Thai population respectively from the measurement of cadavers. Lai et al [5] and Niyaz et al [6] measured the distance of medial rectus by a caliper in the esotropic and exotropic patients who underwent strabismus surgery and in the control group when a buckling surgery for retinal detachment was performed. Lai et al [5] found the distance from the insertion location to the limbus of medial rectus was 5.2 mm in the control group and 5.3 mm in the strabismus group in Taiwanese (Han Chinese) population.…”

Section: Discussionmentioning

confidence: 99%

“…Lai et al [5] found the distance from the insertion location to the limbus of medial rectus was 5.2 mm in the control group and 5.3 mm in the strabismus group in Taiwanese (Han Chinese) population. Niyaz et al [6] found the distance for the medial rectus was 5.7 mm in esotropic group, 6.0 mm in exotropic group and 5.6 mm in the control group respectively in Turkish population. Lai et al [5] and Niyaz et al [6] found medial rectus insertion was not statistically different in esotropia, exotropia, and control patients.…”

Section: Discussionmentioning

confidence: 99%

“…The patient who was found with a mass in the pituitary underwent brain tumor surgery. The distance from the midpoint insertion of medial rectus to the sclerocorneal limbus was measured with a caliper before the muscle was cut and after the muscle was hooked in patients who underwent strabismus surgery [5, 6]. Deviation, stereopsis, and binocular function were remeasured during the follow-up period (1 week to 2 years).…”

Section: Methodsmentioning

confidence: 99%

“…We also used t test to compare the age, refractive error and insertion of medial rectus in AACE patients and exotropic patients. We used case number, mean and SD for t test comparison by using an online t test calculator as Lai [5] did in their study since we cannot get the raw data of Apt’s [7] and Lai’s [5] and Niyaz’s [6] studies (please also see http://www.graphpad.com/quickcalcs/ttest1.cfm). A P value of <0.05 was considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

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Clinical characteristics and surgical outcomes of acute acquired Comitant Esotropia

Cai

Dai²,

Shen

2019

BMC Ophthalmol

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Background To describe the clinical characteristics and the outcomes of strabismus surgery for acute acquired comitant esotropia (AACE). Methods Medical records of 45 AACE patients were retrospectively analyzed. The insertion location of medial rectus was compared between the AACE patients and comitant exotropic patients. The location was also compared with those measured in other studies. Surgical outcome measurements included amount of deviation and level of binocularity at last follow-up. Results The distance from medial rectus to limbus was shorter in AACE patients than in patients with comitant exotropia. The distance was also shorter in AACE patients than patients in other studies. Out of the 45 patients, 2 had neurological diseases. Neostigmine test was negative in all patients. The age at onset of AACE was 5–47 years (mean 19.1 ± 7.3 years), one patient was 5 years (2.2%), 20 patients were 11–17 years (44.5%) and the other 24 patients were 18–47 years old (53.3%). The mean cycloplegic refraction was − 4.1 ± 3.0 diopters (D) and 41 patients were myopic (91%). The angle of deviation was 40.5 ± 19.5 prism diopters (PD) at distance and 35.6 ± 19.9PD at near preoperatively. The angle was 0.8 ± 1.6 PD at distance and 0.7 ± 1.8 PD at near postoperatively. Diplopia resolved in patients who underwent strabismus surgery, with no recurrence during the follow-up period. Thirty patients had stereopsis postoperatively. Conclusions AACE seems to occur mostly in older children and adults and myopes. The distance from the insertion to limbus of medial rectus was shorter in patients with AACE. Good results can be achieved by strabismus surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Clinical characteristics and surgical outcomes of acute acquired Comitant Esotropia

Cai

Dai²,

Shen

2019

BMC Ophthalmol

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Efforts to improve the surgical outcome for exotropia and investigation of the insertion locations of the extraocular muscles

Lai

Chang

2023

The Kaohsiung J of Med Scie

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In our previous retrospective study, we found that using the strabismus surgery dosages established by western strabismus mentors tends to result in undercorrection of Taiwanese exotropia (XT) patients compared with those in western populations. We also discovered that the location of extraocular muscle (EOM) insertion could vary by ethnicity. In this study, using a generalized estimation equation model, we compared the XT surgery outcome between augmented and original strabismus surgery dosages in Taiwanese patients. We also conducted an observational study to investigate the horizontal EOM insertion location in a Taiwanese population and compared the data with Dr. Apt L.'s study. For Taiwanese XT patients, augmented surgical dosages resulted in significantly better outcome at 6 months and 1 year postoperatively compared with original surgical dosages (p = 0.003 and p < 0.001, respectively). The distance from the lateral recuts muscle (LR) insertion location to the limbus was significantly shorter in Taiwanese than in white Americans (6.5 vs. 6.9 mm, respectively, p = 0.0001). Furthermore, the medial rectus muscle and LR insertion locations differed significantly between males and females (p < 0.001 and p = 0.023, respectively). The patients' sex did not affect the surgery outcome. Augmented surgery doses modified from western strabismus mentors produce better surgery outcome for Taiwanese XT patients. Surgeons may require country‐specific guidelines for strabismus surgery dosage. We also demonstrated a simple method for young ophthalmologists to establish their own normograms to improve their surgical success rate. Our study confirms that LR insertion locations differ between Taiwanese and White Americans.

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Yearly changes in cases of acute acquired comitant esotropia during a 12-year period

Okita

Kimura

Masuda

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose The number of patients with acute acquired comitant esotropia (AACE) has been increasing in Japan. The purpose of this study was to investigate the changes in the number and characteristics of patients with AACE examined in our institution during a 12-year period. Methods We retrospectively reviewed the medical records of patients with AACE aged < 30 years who suddenly developed diplopia or esotropia and were examined in Hyogo College of Medicine Hospital from January 2008 to December 2021. We investigated the association of the yearly changes in the number of patients with the age category, refractive error category, AACE type, esotropia type, and use or nonuse of smartphones. Results The total number of patients with AACE was 171, and this number significantly increased each year (Pearson correlation coefficient, 0.9450; p < 0.0001). Significant increases were found among students in junior high school and beyond, patients with myopia, patients with Bielschowsky type AACE, and patients with basic esotropia (p < 0.0001 for all). We compared two age groups, elementary school students and below versus junior high school students and above, and found that the rate of increase was significantly higher in the junior high school students and above (estimate, 1.951; p < 0.0001), and the non-myopia group and myopia group and found that the rate of increase was significantly higher in the myopia group (estimate, 1.891; p < 0.0001). Excessive use of smartphones was confirmed in 82 of 133 patients, and the rate of the increase in the number of patients with AACE was significantly greater among patients with than without excessive use of smartphones (estimate, 1.098; p = 0.0009). Conclusion This study confirmed a significant increase in the number of patients with AACE in recent years. The excessive use of smartphones may be associated with the increase in AACE.

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Medial and Lateral Rectus Muscle Insertion Distance and Width in Esotropia and Exotropia Patients

Abstract: Insertion distances of the medial and LR muscles are not statistically different in ET, XT, and control patients. Only MR muscle width was affected by the size of the deviation in ET patients.

Cited by 5 publications

References 5 publications

Clinical characteristics and surgical outcomes of acute acquired Comitant Esotropia

Clinical characteristics and surgical outcomes of acute acquired Comitant Esotropia

Efforts to improve the surgical outcome for exotropia and investigation of the insertion locations of the extraocular muscles

Yearly changes in cases of acute acquired comitant esotropia during a 12-year period

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