Myopexie Retro-Equatoriale, après Transposition Selon Hummelsheim, dans le Traitement de la Paralysie du VIème Nerf Crânien

Klainguti, G.; Gianoli, Fabrice; Mataftsi, Asimina

doi:10.1055/s-2003-38185

Cited by 1 publication

(1 citation statement)

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“…None of their patients developed anterior segment ischemia. Klainguti et al 16 performed posterior fixation of the contralateral medial rectus in addition to the Hummelsheim procedure in 2 patients with sixth nerve palsy and reported favorable results with this combination. Rectus muscle plication reduces the likelihood of ischemia in the lost muscle and anterior segment.…”

Section: Discussionmentioning

confidence: 99%

Anterior Segment Ischemia after Strabismus Surgery

Göçmen¹,

Atalay²,

Kemer³

et al. 2017

tjo

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A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day), cyclopentolate hydrochloride drops (3 times/day) and 20 mg oral fluocortolone (3 times/day) was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken.

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Section: Discussionmentioning

confidence: 99%