Rectus muscle orbital wall fixation: A reversible profound weakening procedure

Velez, Federico G.; Thacker, Neepa; Britt, Michelle T.; Alcorn, Deborah M.; Foster, Roger S.; Rosenbaum, Arthur L.

doi:10.1016/j.jaapos.2004.06.011

Cited by 73 publications

(43 citation statements)

References 23 publications

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“…Simons 12 in a retrospective study of 33 patients using transposition techniques of horizontal rectus muscles reported a success rate of 86%. Velez and colleagues 13 and Sristava and colleagues 14 report similar success rates. Results from the largest published series of surgery for oculomotor nerve palsy surgery are compared in Table 5.…”

Section: Discussionmentioning

confidence: 78%

Predictive factors of surgical outcome in oculomotor nerve palsy

Cabrejas

Hurtado-Ceña

Tejedor

2009

Journal of American Association for Pediatric Ophthalmology and

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Section: Discussionmentioning

confidence: 78%

Predictive factors of surgical outcome in oculomotor nerve palsy

Cabrejas

Hurtado-Ceña

Tejedor

2009

Journal of American Association for Pediatric Ophthalmology and

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“…3 For treatment of esotropic Duane syndrome with severe globe retraction, transposition of the lateral half of the vertical rectus muscles to the lateral rectus insertion was combined with fixation of the lateral rectus muscle to the periosteum of the lateral orbital wall. [4][5][6][7] Although the outcome of periosteal fixation of the lateral rectus muscle may be excellent, exposing the adjacent periosteum and passing the needle through it is technically difficult. 5 In our procedure, the lateral rectus muscle is instead attached to the lateral canthal tendon.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Although the outcome of periosteal fixation of the lateral rectus muscle may be excellent, exposing the adjacent periosteum and passing the needle through it is technically difficult. 5 In our procedure, the lateral rectus muscle is instead attached to the lateral canthal tendon. This structure can easily be identified by its appearance and relatively superficial location because it inserts at Whitnall's tubercle.…”

Section: Discussionmentioning

confidence: 99%

Profound weakening of the lateral rectus muscle with attachment to lateral canthal tendon for treatment of exotropic Duane syndrome

Sukhija

Singh

2012

Journal of American Association for Pediatric Ophthalmology and

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“…A more aggressive approach to exo-Duane syndrome is to maximally weaken the lateral rectus muscle by disinsertion and fixation to the adjacent periosteal wall. [16][17][18] This procedure similarly removes the lateral rectus from the crest of the globe, thereby diminishing slippage and up-or downshoots, and also addresses exotropia. However, this procedure often requires an additional procedure such as medial orbital wall fixation, vertical rectus transposition, or medial rectus recession to avoid a consecutive esotropia.…”

Section: Discussionmentioning

confidence: 99%

Isolated Y-splitting and recession of the lateral rectus muscle in patients with exo-Duane syndrome

Yoo¹,

Hendler²,

Velez³

et al. 2012

Journal of American Association for Pediatric Ophthalmology and

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Purpose-Weakening of both horizontal rectus muscles is performed for patients with Duane syndrome and significant misinnervation of the lateral rectus (LR) muscle resulting in strabismus, limitation to ocular rotations, and globe retraction. In patients with severe up-/downshoots, a Ysplitting of the LR is often recommended. The purpose of this study was to evaluate the efficacy of isolated unilateral LR recession-Y splitting in exo-Duane patients with limitation to adduction and up-/downshoots. Methods-Retrospective review of the records of consecutive patients with exo-Duane syndrome and up/downshoots who underwent isolated Y-splitting-recession of the affected LR.Results-The records of 10 patients were reviewed (mean age at surgery 23 ± 21 years). The Ysplit was performed 10 mm posterior to the insertion and was combined with a mean LR recession of 8.7 ± 2.9 mm. Torticollis decreased from 12.7 ± 4.4° to 4.8 ± 5.3° (P = 0.003). Exotropia improved from 18.4 ± 7.3 to 6.2 ± 5.9 PD postoperatively (P < 0.001). Exotropia in contralateral gaze improved from 33.7 ± 11.8 to 18.7 ± 18.1 PD postoperatively (P = 0.09). No significant postoperative changes in esotropia in ipsilateral gaze, vertical deviations, or ocular rotations in adduction or abduction were observed. Downshoots were significantly decreased (P = 0.01), and there was a trend toward improvement of upshoots (P = 0.07). There were no overcorrections, although 3 patients required additional LR weakening and transposition.Conclusions-LR Y-splitting-recession improves ocular alignment, torticollis, and up-/ downshoots. LR recession improves ocular alignment and torticollis, while the addition of a Ysplit procedure improves up-/downshoots.

show abstract

Rectus muscle orbital wall fixation: A reversible profound weakening procedure

Cited by 73 publications

References 23 publications

Predictive factors of surgical outcome in oculomotor nerve palsy

Predictive factors of surgical outcome in oculomotor nerve palsy

Profound weakening of the lateral rectus muscle with attachment to lateral canthal tendon for treatment of exotropic Duane syndrome

Isolated Y-splitting and recession of the lateral rectus muscle in patients with exo-Duane syndrome

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