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Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia

PURPOSE: To evaluate using the resected medial rectus muscle for elongation of the lateral rectus tendon in monocular surgery for large-angle sensory exotropia. PATIENTS AND METHODS: A prospective case series was carried out in Tanta University hospital from January 2017 to June 2018 including 16 pa...

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Autores principales: Shafik, Heba M, Eldesouky, Mohamed Ashraf, Tadros, Dina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386811/
https://www.ncbi.nlm.nih.gov/pubmed/32801622
http://dx.doi.org/10.2147/OPTH.S253628
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author Shafik, Heba M
Eldesouky, Mohamed Ashraf
Tadros, Dina
author_facet Shafik, Heba M
Eldesouky, Mohamed Ashraf
Tadros, Dina
author_sort Shafik, Heba M
collection PubMed
description PURPOSE: To evaluate using the resected medial rectus muscle for elongation of the lateral rectus tendon in monocular surgery for large-angle sensory exotropia. PATIENTS AND METHODS: A prospective case series was carried out in Tanta University hospital from January 2017 to June 2018 including 16 patients with large-angle sensory exotropia ≥50PD. The near and distance angles of exotropia were measured; any restrictions in adduction or abduction were recorded and scaled from −4 to 0. Resection of the medial rectus muscle was done first; the resected segment was attached to the lateral rectus muscle after dissection by mattress sutures, and the muscle was recessed after elongation according to the preoperative distance angles. Successful motor alignment was considered if the angle measurement was within 10 PD of orthotropia at distance after 6 months. The stability of the alignment, any motility restrictions, and patient satisfaction were recorded at each follow-up visit until the 6th month. RESULTS: The mean age of the study patients was 30.68±13.30 years. The best-corrected visual acuity of the exotropic eyes by logMAR was 1.2±0.3; the mean of the preoperative distance angle of deviation was −72.19 ±14.26 PD. The mean preoperative adduction and abduction restrictions were −1.19 ±1.52 and −1.13 ±1.09, respectively. There was significant improvement in the distance angle of deviation at the last follow-up after 6 months (p=0.001*). Also, there was improvement in both adduction and abduction restriction from the first to last follow-up. Thirteen patients (81.2%) were satisfied at the 6-month follow-up. CONCLUSION: Elongation of the lateral rectus muscle by an autograft from the resected medial rectus muscle is an easy, effective procedure for large-angle sensory exotropia. Patients achieve good postoperative alignment with minimal restriction of ocular motility.
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spelling pubmed-73868112020-08-13 Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia Shafik, Heba M Eldesouky, Mohamed Ashraf Tadros, Dina Clin Ophthalmol Original Research PURPOSE: To evaluate using the resected medial rectus muscle for elongation of the lateral rectus tendon in monocular surgery for large-angle sensory exotropia. PATIENTS AND METHODS: A prospective case series was carried out in Tanta University hospital from January 2017 to June 2018 including 16 patients with large-angle sensory exotropia ≥50PD. The near and distance angles of exotropia were measured; any restrictions in adduction or abduction were recorded and scaled from −4 to 0. Resection of the medial rectus muscle was done first; the resected segment was attached to the lateral rectus muscle after dissection by mattress sutures, and the muscle was recessed after elongation according to the preoperative distance angles. Successful motor alignment was considered if the angle measurement was within 10 PD of orthotropia at distance after 6 months. The stability of the alignment, any motility restrictions, and patient satisfaction were recorded at each follow-up visit until the 6th month. RESULTS: The mean age of the study patients was 30.68±13.30 years. The best-corrected visual acuity of the exotropic eyes by logMAR was 1.2±0.3; the mean of the preoperative distance angle of deviation was −72.19 ±14.26 PD. The mean preoperative adduction and abduction restrictions were −1.19 ±1.52 and −1.13 ±1.09, respectively. There was significant improvement in the distance angle of deviation at the last follow-up after 6 months (p=0.001*). Also, there was improvement in both adduction and abduction restriction from the first to last follow-up. Thirteen patients (81.2%) were satisfied at the 6-month follow-up. CONCLUSION: Elongation of the lateral rectus muscle by an autograft from the resected medial rectus muscle is an easy, effective procedure for large-angle sensory exotropia. Patients achieve good postoperative alignment with minimal restriction of ocular motility. Dove 2020-07-24 /pmc/articles/PMC7386811/ /pubmed/32801622 http://dx.doi.org/10.2147/OPTH.S253628 Text en © 2020 Shafik et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Shafik, Heba M
Eldesouky, Mohamed Ashraf
Tadros, Dina
Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_full Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_fullStr Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_full_unstemmed Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_short Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_sort lateral rectus muscle tendon elongation by an auto graft from the resected medial rectus muscle as a monocular surgery for large-angle sensory exotropia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386811/
https://www.ncbi.nlm.nih.gov/pubmed/32801622
http://dx.doi.org/10.2147/OPTH.S253628
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