J Korean Ophthalmol Soc.  2009 Jul;50(7):1128-1132. 10.3341/jkos.2009.50.7.1128.

A Case of Rectus Muscle Transposition With Silicone Band in Strabismus Fixus With High Myopia

• Lee JS
• Heo H
• Park SW
• Park YG

• KMID: 2212506
• DOI: http://doi.org/10.3341/jkos.2009.50.7.1128

Abstract

PURPOSE
To present a surgical result of rectus muscle transposition with silicone band without suture on the sclera in strabismus fixus with high myopia. CASE SUMMARY: A 73-year-old female patient with a 20-year history of bilateral esotropia and hypotropia visited our clinic. The patient`s right eye was aphakic because crystalline lens removal was performed 17 years earlier and the left eye was phthisical after retinal detachment, due to high myopia. Ocular movements in both eyes were severely restricted in all directions with the cornea barely visible. Ultrasound examination revealed posterior staphyloma of the retina. The axial length measurement was 32 mm in the right eye, and could not be measured in the left eye. Posterior tenon fixation of the medial rectus and inferior rectus muscle tendon was performed, in addition, fixation of the lateral half of the superior rectus and superior half of the lateral rectus muscle on the silicone band 10 mm posterior to each muscle's scleral insertion as a transposition procedure was performed. At 6 months postoperatively, there was no residual esotropia or hypotropia. The right eye maintained a gaze limitation but improved abduction and supraduction. CONCLUSIONS: In strabismus fixus with high myopia, posterior tenon fixation and muscle transposition with silicone band is an effective method without complication.

Keyword

High myopia; Silicone band; Strabismus fixus

MeSH Terms

Aged
Cornea
Esotropia
Eye
Female
Humans
Lens, Crystalline
Muscles
Myopia
Retina
Retinal Detachment
Sclera
Silicones
Strabismus
Sutures
Tendons
Silicones

Figure

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  Figure 1. (A) Preoperative photograph shows both eyes fixed in a position of extreme adduction and infraduction in 73-year-old female patient. (B) Postoperative three-month photograph shows straight alignment in primary position and improved abduction and supraduction in the right eye.

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  Figure 2. Intraoperative findings demonstrate (A) the path of the lateral rectus (arrow) muscle was dislocated into the inferotemporal quadrant of the globe and the superior rectus muscle (arrow head) was dislocated into the superonasal quadrant of the globe, caused by the scleral distension. (B) The edge of silicone band (arrow) sutured to the lateral part of the superior rectus (SR) and the superior part of the lateral rectus (LR) muscles is shown, and the silicone band is not sutured onto the sclera.

Reference

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