A modified vertical muscle transposition for the treatment of large-angle esotropia due to sixth nerve palsy

Sabermoghadam, Aliakbar; Razavi, Mohammad Etezad; Sharifi, Mohammad Davood; Kiarudi, Mohammad Yaser; Ghafarian, Sadegh

doi:10.1080/09273972.2018.1492621

Cited by 12 publications

(12 citation statements)

References 12 publications

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“…29 A success rate was obtained in 20/32 (62.50%) patients with an under-correction in 12/32 (37.50%) patients, which was substantially lower than that in patients with CN VI palsy (78%-100%). 30,31 Several limitations of this study should be considered. First, as this study focused only on isolated MRP, it would not be possible to determine the incidence of MRP along with other palsies of extraocular muscles.…”

Section: Discussionmentioning

confidence: 96%

“…When medial rectus muscle repair was not possible and there was sufficient scar formation around the ruptured muscle, lateral rectus recession and medial rectus resection were also used to correct the deviation, as Chen et al's study suggested 29 . A success rate was obtained in 20/32 (62.50%) patients with an under‐correction in 12/32 (37.50%) patients, which was substantially lower than that in patients with CN VI palsy (78%‐100%) 30,31 …”

Section: Discussionmentioning

confidence: 99%

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Aetiology, clinical features and surgical outcomes of isolated medial rectus palsy

Zhu

Wang

Yan

2020

Clinical Exper Ophthalmology

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Importance Isolated medial rectus palsy is extremely rare in clinical practice. Background To report demographics, aetiology, clinical findings, imaging features and surgical outcomes in patients with isolated medial rectus palsy. Design Retrospective study. Participants All patients treated for isolated medial rectus palsy at Zhongshan Ophthalmic Center, Sun Yat‐sen University, between September 2003 and March 2019. Methods Review of patient records. Main Outcome Measures Aetiology, clinical findings, imaging features and surgical outcomes. Results A total of 32 patients (22 males, 10 females) were included. Mean age was 33.19 ± 19.78 years. The right eye was involved in 17 patients, the left eye was involved in 14 patients, and both eyes were involved in one patient. The most common causes were iatrogenic injury (43.75%), followed by trauma (37.50%) and congenital (18.75%). The most common clinical findings included outward deviation, diplopia and limited adduction. Six patients showed combined small‐angle vertical strabismus, and 10 patients experienced a scale of −1 motility defect in other directions. After individualized strabismus surgery, preoperative exotropia of 60 ± 25 prism diopters (PD) was significantly reduced to 12 ± 13 PD (t = 10.938, P < .0001). Ocular motility improved in 21 patients, and five patients achieved normal ocular motility. Successful correction was obtained in 20/32 (62.50%) patients, with under‐correction in 12/32 (37.50%) patients. Twenty‐eight patients had only one surgery, three patients had two surgeries and one patient had three surgeries. Conclusions and Relevance The most common cause of isolated medial rectus palsy was local injury. Satisfactory results were obtained after individualized surgical interventions based on personalized preoperative evaluations.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Aetiology, clinical features and surgical outcomes of isolated medial rectus palsy

Zhu

Wang

Yan

2020

Clinical Exper Ophthalmology

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“…It involves making radial conjunctival incision in superotemporal and inferotemporal quadrants, and it could be done with Cul-de-sac or MISS incisions. 26 The surgical correction by muscle transposition alone ranges from 24 to 36 PD, and that by muscle transposition and recession of the medial rectus muscle increases up to 62 PD. The most important feature of this procedure compared with the other procedures is that this technique is surgically more straightforward and minimal, with less damage to the ocular fascia.…”

Section: R Esultsmentioning

confidence: 99%

Minimal invasive procedures in strabismus surgery: A narrative review

Mojon,

Kiarudi,

Sabermoghaddam

et al. 2023

J Curr Ophthalmol

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“…In chronic sixth cranial nerve palsies, surgery is indicated when spontaneous resolution does not take place after 6 months, 1 2 although some studies consider waiting even up to 10 months. 3 4 5 The amount of residual function of lateral rectus (LR) muscle is very important for determining the surgical plan. A simple way is to score LR function (abduction) deficiency.…”

Section: Introductionmentioning

confidence: 99%

A Review of Transposition Techniques for Treatment of Complete Abducens Nerve Palsy

Akbari

Masoomian

Mirmohammadsadeghi

et al. 2021

Journal of Current Ophthalmology

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Purpose: To review various types of extraocular muscle transposition procedures for management of strabismus in sixth cranial nerve palsy with little lateral rectus (LR) muscle function, along with their pros and cons. Methods: We performed a comprehensive review of transposition procedures in sixth cranial nerve palsy, based on literature published anytime up to March 2021. A thorough search through PubMed and Cochrane databases was performed. All types of clinical studies on different transposition procedures in LR palsy, were included. Results: Eighty-six original articles in English, with full text or abstracts available, were included in the review, among which 16 are prospective studies, 48 retrospective, 3 review articles, 1 randomized clinical trial, 17 case reports, and 1 letter. Vertical rectus transposition has demonstrated promising results, especially in abduction improvement and expansion of binocular diplopia-free visual field, albeit the possible adverse effects such as anterior segment ischemia, especially in the presence of medial rectus contracture, and induced vertical deviation may become troublesome. Partial muscle transposition, single muscle transposition, and also transposition without tenotomy have all been introduced to reduce the risk of multiple muscle manipulation and ischemia. On the other hand, different adjustable transpositions are being utilized to manage concomitant or induced vertical deviations. Conclusion: Transposition procedures are highly effective in the treatment of esotropia caused by complete LR palsy. Various techniques for vertical muscle transposition have been proposed, with each of them having certain advantages and disadvantages.

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A modified vertical muscle transposition for the treatment of large-angle esotropia due to sixth nerve palsy

Abstract: This procedure is comparable to traditional procedures with the advantages of no need to tenotomy or splitting and can be a good alternative to conventional Hummelsheim's procedure.

Cited by 12 publications

References 12 publications

Aetiology, clinical features and surgical outcomes of isolated medial rectus palsy

Aetiology, clinical features and surgical outcomes of isolated medial rectus palsy

Minimal invasive procedures in strabismus surgery: A narrative review

A Review of Transposition Techniques for Treatment of Complete Abducens Nerve Palsy

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