A Muscle Transposition Procedure for Abducens Palsy, in Which the Halves of the Vertical Rectus Muscle Bellies Are Sutured Onto the Sclera

Nishida, Yasuhiro; Inatomi, Akihiro; Aoki, Yoshiko; Hayashi, Osamu; Iwami, Tatsuya; Oda, Sanae; Nakamura, Jiro; Kani, Kazutaka

doi:10.1016/s0021-5155(03)00021-2

Cited by 57 publications

(26 citation statements)

References 20 publications

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“…Other procedures such as the Jensen procedure, vertical rectus muscle splitting with transposition without tenotomy, 23 and vertical rectus muscle transposition without tenotomy as described by Nishida et al 24,25 were not evaluated. Recently, we have adopted the augmented superior rectus muscle transposition with medial rectus muscle recession as described by Mehendale et al; however, this study period did not include those patients.…”

Section: Discussionmentioning

confidence: 99%

Functional and Motor Outcomes of Strabismus Surgery for Chronic Isolated Adult Sixth Nerve Palsy

Peragallo¹,

Hutchinson²,

Lenhart³

et al. 2014

Neuro-Ophthalmology

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Abducens nerve palsy is the most common acquired ocular motor nerve palsy in adults. Chronic cases of abducens palsy often require surgical intervention to relieve disabling diplopia. The goal of this study was to identify factors associated with surgical outcomes in isolated abducens palsy. Medical records of all adult patients from 1988 to 2012 with abducens palsies who underwent strabismus procedures were retrospectively reviewed. Motor alignment, extraocular motility, and sensory outcomes were recorded. Success was defined as absence of diplopia without prisms or face turn, vertical deviation 2 prism dioptres (PD), and horizontal deviation 10 PD. Eighty-one patients (age range: 20-86 years) met inclusion criteria. Success was achieved in 58% of patients. Final success rates for abducens palsy were 50% for neoplastic, 59% traumatic, 57% for microvascular/unknown, and 67% for other central nervous system causes (p40.05). Patients with an underlying neoplastic or traumatic aetiology required more than one strabismus procedure more often than those with microvascular/idiopathic or other central nervous system causes (48% vs. 24%; p = 0.03). For complete abducens palsies, patients who underwent Hummelsheim-type procedures had a higher success rate than those who underwent a full-tendon vertical rectus muscle transposition. (78% versus 35%; p = 0.049). Success rates for strabismus procedures in patients with abducens palsies are similar across all aetiologies. Frequency of re-operation is higher among those patients with neoplastic or traumatic aetiologies for their abducens palsies. Hummelsheim-type procedures have a higher success rate for complete abducens palsies than full-tendon vertical rectus transpositions.

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Section: Discussionmentioning

confidence: 99%

Functional and Motor Outcomes of Strabismus Surgery for Chronic Isolated Adult Sixth Nerve Palsy

Peragallo¹,

Hutchinson²,

Lenhart³

et al. 2014

Neuro-Ophthalmology

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“…A muscle transposition procedure without tenotomy, which we previously reported, was performed in two cases (Case 1 and Case 2), which were followed for 26 and 25 years, respectively ( Figure 1a). 1 In this procedure, a suture was secured at the lateral margin of each split vertical rectus muscle and each sclera beside the superior or inferior margin of the lateral rectus (LR) muscle. The lateral half of each vertical rectus muscle belly was transposed and anchored to the sclera.…”

Section: Methodsmentioning

confidence: 99%

“…Many previous papers have reported that a muscle transposition procedure was effective for abducens palsy. [1][2][3][4][5][6][7][8] However, the stability of the effectiveness long term has not been revealed because few reports have discussed follow-up for 10 years after a muscle transposition procedure for abducens palsy. [5][6][7] Therefore, we report long-term outcomes (410 years) of three cases that underwent a muscle transposition procedure due to abducens palsy.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Three Cases That Underwent a Muscle Transposition Procedure Without Tenotomy Caused by Abducens Palsy

Higashiyama

Nishida

Muraki

et al. 2014

Neuro-Ophthalmology

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Few reports have discussed long-term outcomes of muscle transposition procedures. In this study, cases with abducens palsy treated with a muscle transposition procedure were followed for 12, 25, or 26 years. The preoperative alignments were esotropia of 65 degrees, 47 prism dioptres (PD), and 24 PD, respectively. Orthophoria was postoperatively achieved in all cases. The postoperative alignment in one case deteriorated at 8 years postoperatively, although orthophoria were maintained in the other two cases. These findings indicate that it is possible that esotropia can recur even though orthophoria was maintained for several years postoperatively in some cases that underwent a muscle transposition procedure.

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“…We planned bilateral transposition myopexy on the vertical recti (a modification of the procedure described by Nishida)6. The major modification from the original Nishida’s procedure was that we passed 5–0 non-absorbable braided polyester suture (Ethibond) 8 mm from muscle insertion in both superior rectus (SR) and inferior rectus (IR) full muscle width (against one-third muscle width done in original Nishida’s technique)7 similar to recession suture and transposed it just at the site of absent MR border, 14 mm behind limbus without tenotomy or muscle splitting (figure 3A–E). Also, in the right eye, 8.5 mm LR recession was done as its force duction test was mildly tight.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Bilateral medial rectus aplasia and a modified surgical approach of transposition myopexy of vertical recti

2017

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A 16-year-old girl presented with left eye large-angle exotropia. On examination, we found bilateral limitation of adduction. CT orbit showed hypoplastic medial rectus bilaterally, but intraoperatively we found absent medial recti on both sides. This case report explains discrepancy between the imaging and the intraoperative findings and discusses the management dilemma in view of the risk of anterior segment ischaemia and how marked exodeviation and adduction limitation was tackled by the new technique of transposition myopexy, a modification of the procedure described by Nishida along with recession of lateral rectus to achieve good alignment. This procedure changes the vector forces of the vertical rectus without splitting or tenotomy of the muscles.

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A Muscle Transposition Procedure for Abducens Palsy, in Which the Halves of the Vertical Rectus Muscle Bellies Are Sutured Onto the Sclera

Cited by 57 publications

References 20 publications

Functional and Motor Outcomes of Strabismus Surgery for Chronic Isolated Adult Sixth Nerve Palsy

Functional and Motor Outcomes of Strabismus Surgery for Chronic Isolated Adult Sixth Nerve Palsy

Long-Term Outcomes of Three Cases That Underwent a Muscle Transposition Procedure Without Tenotomy Caused by Abducens Palsy

Bilateral medial rectus aplasia and a modified surgical approach of transposition myopexy of vertical recti

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