Recognition and Repair of the “Lost” Rectus Muscle

Plager, David A.; Parks, Marshall M.

doi:10.1016/s0161-6420(90)32636-2

Cited by 93 publications

(62 citation statements)

References 5 publications

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“…A muscle is declared to be lost if it is completely detached from the globe surgically or by trauma and retracted posteriorly (Plager & Parks 1990). Following trauma the most commonly injured and avulsed extraocular muscles in decreasing order are the medial, inferior, superior and lateral recti and the obliques (Mailer 1974).…”

Section: Discussionmentioning

confidence: 99%

“…Following trauma the most commonly injured and avulsed extraocular muscles in decreasing order are the medial, inferior, superior and lateral recti and the obliques (Mailer 1974). Retrieval of the superior, inferior and lateral recti is facilitated by their inti-mate attachments to the oblique muscles in the sub-Tenon's space (Plager & Parks 1990). Also, it has been suggested that reoperation on a lost muscle should be performed within 7 to 10 days after the initial surgery before the contracture of the lost muscle or its antagonist supervenes (Plager & Parks 1990).…”

Section: Discussionmentioning

confidence: 99%

“…Retrieval of the superior, inferior and lateral recti is facilitated by their inti-mate attachments to the oblique muscles in the sub-Tenon's space (Plager & Parks 1990). Also, it has been suggested that reoperation on a lost muscle should be performed within 7 to 10 days after the initial surgery before the contracture of the lost muscle or its antagonist supervenes (Plager & Parks 1990). The relatively short interval between the accident and surgery in our patient might have contributed to the successful retrieval of two recti muscles in such a disorganized orbit.…”

Section: Discussionmentioning

confidence: 99%

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Management of traumatic luxation of the globe. A case report

Kıratlı

Tümer

Bilgiç

1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To report the management of a patient who had LeFort type III fractures and traumatic luxation of the globe with avulsion of the optic nerve and all extraocular muscles except for the medial rectus. Methods: Eight hours after the trauma, the detached and retracted superior and lateral recti muscles could be found and sutured to their original insertions. The inferior rectus could not be retrieved. Results: Although the left eye had no light perception, most of its motility was restored resulting in an unblemished cosmesis. Conclusion: Avoiding primary enucleation helped to alleviate the psychological burden of the trauma on the patient. In case of the eventual development of phthisis bulbi, the patient will have a chance to be fitted with a prosthesis over his own eye with a resulting better motility.Key words: avulsion -optic nerve -extraocular muscle -trauma -orbit.Acta Ophthalmol. Scand. 1999: 77: 340-342 Copyright c Acta Ophthalmol Scand 1999. ISSN 1395-3907 A vulsion of the globe (avulsio bulbi) can be classified as avulsion of the optic nerve only (avulsio incompleta) or with accompanying disruption of the extraocular muscles (avulsio completa) which may cause total luxation of the ocular bulbus (Lang et al. 1991). Fortunately, luxatio bulbi is a rare event, so much so that it was alluded to as a medical curiosity just before the turn of the century in 1896 (Gould & Pyle 1956). Paradoxically, a hundred years after the compilation of this record of rare medical events, this extreme form of trauma still fascinates the professionals, possibly as a result of the continuing appearance of sporadic reports. We herein describe a patient with avulsio bulbi who is slightly different from those in the literature in that he was not managed by enucleation. Report of a CaseA 29-year-old man sustained severe facial injuries after a motor vehicle accident while driving with blood alcohol levels far beyond the legal limits. He was hospitalized in an unconscious state and was not arousable to verbal stimuli. He had deep facial lacerations on both sides which included the lower eyelids and the left upper eyelid. The left globe was luxated to over the skin of the upper lid below the brows. Posterior portions of the globe were surrounded by edematous Tenon's and orbital fat. The optic nerve was seemingly avulsed from just behind the globe as there was a 1 mm stump attached to the bulbus. Except for the medial rectus, all extraocular muscles were severed at 2-3 mm posterior to their insertions. The conjunctiva was torn at the limbus and retracted posteriorly. The eyeball was slightly hypotonic but intact. The cornea was cloudy and the pupil was widely dilated. There was no direct or indirect reaction to light. No view of the fundus could be obtained. Cranial computed tomographic (CT) images showed LeFort type III facial fractures and were suggestive of avulsion of the optic nerve within the left orbit (Fig. 1). Intracranial structures and the right eye were normal. Intravenous corticosteroids and antibio...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of traumatic luxation of the globe. A case report

Kıratlı

Tümer

Bilgiç

1999

Acta Ophthalmologica Scandinavica

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“…A lost muscle has no attachment to the globe. Plager & Parks (1990) reported that 67% of lost superior, inferior, and lateral rectus muscles were retrievable while only 10% of lost medial rectus muscles were retrievable. MacEwen et al (1992) found that medial rectus muscles that were cut and lost during strabismus surgery are seldom located, but snapped or traumatically severed muscles are frequently located.…”

Section: Introductionmentioning

confidence: 99%

Vertical Muscle Transposition with Augmentation for Treatment of Exotropia Caused by Iatrogenic Lost Medial Rectus Muscle

2016

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Purpose: To evaluate the results of vertical muscle transposition with augmentation in cases of exotropia caused by iatrogenic lost medial rectus muscle.Methods: This is a retrospective review of 5 cases of lost medial rectus with exotropia and marked limitation of adduction that underwent surgery. All cases had a history of strabismus surgery on the medial rectus and failed attempt at retrieval of the lost muscle.

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“…Extraocular muscle avulsion of traumatic etiology is not fre quent (1,2) . The medial and inferior recti are the most frequently inju red muscles.…”

Section: Introductionmentioning

confidence: 99%

Traumatic avulsion of extraocular muscles: case reports

Minguini¹,

Ikeda²,

Carvalho³

2013

Arq. Bras. Oftalmol.

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We described the clinical, surgical details and results (motor and sensory) of the retrieving procedure of traumatically avulsed muscles in three patients with no pre vious history of strabismus or diplopia seen in the Department of Ophthalmolo gy, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.

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Recognition and Repair of the “Lost” Rectus Muscle

Cited by 93 publications

References 5 publications

Management of traumatic luxation of the globe. A case report

Management of traumatic luxation of the globe. A case report

Vertical Muscle Transposition with Augmentation for Treatment of Exotropia Caused by Iatrogenic Lost Medial Rectus Muscle

Traumatic avulsion of extraocular muscles: case reports

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