The role of rectus muscle myectomy in the management of large-angle strabismus for Graves’ ophthalmopathy

Liao, Shu‐Lang; Wei, Yi‐Hsuan; Chuang, A Y-C

doi:10.1038/eye.2017.28

Cited by 10 publications

(2 citation statements)

References 23 publications

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“…These findings are consistent with our results. We postulated that the MR had limited orbital space to access compared with other recti muscles, hence requiring more force to expose the muscle and more vulnerable to a significant elevation of the IOP during the procedure [ 13 ]. Surgeons should be aware of the possibility of IOP elevation during strabismus surgery in patients with TED, especially during MR recession.…”

Section: Discussionmentioning

confidence: 99%

Sequential changes in intraocular pressure during strabismus surgery in patients with thyroid eye disease

Jeong

Kim

2022

BMC Ophthalmol

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Background/Aims To investigate the sequential change in intraocular pressure (IOP) during strabismus surgery in patients with thyroid eye disease (TED). Methods This prospective study included patients with TED who underwent strabismus surgery (medial rectus [MR], inferior rectus [IR], and superior rectus [SR] recession) between March 2018 and December 2020. The IOP was measured six times during surgery (5 min after intubation, after isolation of the muscle using a hook and dissection of the surrounding tissue, immediately before muscle detachment, immediately after muscle detachment, after reattachment of the muscle, and after closure of the conjunctiva). Results Thirty-five eyes of 18 patients were included. The mean IOP at first was 21.1 mmHg, which significantly increased to 28.6 mmHg after muscle isolation. The IOP significantly decreased to 15.5 mmHg after muscle detachment. This increased to 19.1 mmHg after muscle reattachment. The last IOP was 18.9 mmHg. There were similar patterns of sequential change in the IOP among the three muscles. The MR showed the highest increase in IOP. The IR showed the lowest mean IOP compared with the other two muscles. Conclusions The IOP was elevated during the isolation and dissection of the surrounding muscle tissue, especially in the MR. The IOP significantly decreased after muscle detachment and was maintained until the last measurement, even after muscle reattachment. IR showed the lowest IOP among the three muscles during surgery.

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Section: Discussionmentioning

confidence: 99%

Sequential changes in intraocular pressure during strabismus surgery in patients with thyroid eye disease

Jeong

Kim

2022

BMC Ophthalmol

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“…17 Liao et al achieved an overall success rate of 91.5% with rectus muscle disinsertion in patients with large-angle strabismus related to thyroid eye disease. 18 LR disinsertion with or without periosteal fixation has been performed to manage Duane retraction syndrome, third cranial nerve palsy, and large-angle exotropia. 19,20 MR disinsertion has been described as a surgical approach in patients with convergence strabismus fixus related to high myopia or bilateral sixth nerve palsy.…”

Section: Discussionmentioning

confidence: 99%

Medial rectus disinsertion for management of chronic complete sixth nerve palsy

Bagheri

Veisi

Tavakoli

2021

European Journal of Ophthalmology

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Purpose To report the outcomes of the medial rectus (MR) disinsertion procedure for the management of refractory esotropia (ET) with or without Abnormal head posture (AHP) in chronic complete sixth nerve palsy. Methods This is a retrospective case series of patients with sixth nerve palsy who suffered from residual ET and diplopia following the conventional strabismus surgeries and underwent MR disinsertion procedure between April 2017 and February 2020. This procedure was offered to the patients who declined to use prism and did not wish to perform surgery on the fellow eye. The demographic and clinical data, including sex, age, visual acuity, pre and postoperative angle of strabismus, duction limitations, results of forced duction and force generation tests, details of prior strabismus surgeries, orbital CT scan findings, and follow up duration were collected from the medical records. Results Six patients were enrolled in this study. Mean age was 35.0 ± 14.0 years, and mean follow-up was 15.3 ± 5.9 months. The ET at the Primary position (PP) was 35.0 ± 18.4 prism dioptre (PD) before MR disinsertion, which decreased to 14.2 ± 17.4 PD after MR disinsertion procedure. Four cases needed additional complementary surgeries to improve residual ET in PP. No case developed overcorrection. Abduction deficiency was −5.0 ± 1.3 before MR disinsertion, which improved to − 2.8 ± 0.5 units at last follow-up. The mean of induced adduction deficiency was − 2.9 ± 0.4 at last follow-up. Conclusions MR disinsertion can be considered in patients with chronic complete sixth nerve palsy and refractory diplopia when the conventional methods have failed.

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Postoperative residual vertical deviation affects quality of life in Asian patients with thyroid-associated ophthalmopathy (Graves ophthalmopathy)

2023

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The role of rectus muscle myectomy in the management of large-angle strabismus for Graves’ ophthalmopathy

Cited by 10 publications

References 23 publications

Sequential changes in intraocular pressure during strabismus surgery in patients with thyroid eye disease

Sequential changes in intraocular pressure during strabismus surgery in patients with thyroid eye disease

Medial rectus disinsertion for management of chronic complete sixth nerve palsy

Postoperative residual vertical deviation affects quality of life in Asian patients with thyroid-associated ophthalmopathy (Graves ophthalmopathy)

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