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Extraocular muscle insertion positions and outcomes of strabismus surgery: correlation analysis and anatomical comparison of Western and Chinese populations
  1. Yu-Hung Lai1,2,3,
  2. Wen-Chuan Wu1,3,
  3. Hwei-Zu Wang1,3,
  4. Hsin-Tien Hsu4
  1. 1Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  2. 2Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  3. 3Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  4. 4School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
  1. Correspondence to Dr Hsin-Tien Hsu, 100 Zih-You 1st Rd, Kaohsiung, 807, Taiwan; hthsu{at}


Background/aims To compare the insertion locations of extraocular muscles between Taiwanese (Han Chinese) and Western populations and to determine whether anatomical differences warrant different surgical guidelines.

Methods Insertion locations were compared between a Taiwanese population of subjects who had received surgical treatment for strabismus and a control group who had not. Insertion locations and surgical outcomes in the strabismus group were also compared with those reported in other countries.

Results In Taiwanese subjects, extraocular muscle insertion locations were not significantly different between strabismus subjects and controls. However, the distances from the insertion location to the limbus of the inferior rectus, lateral rectus and superior rectus were significantly shorter in the Taiwanese subjects than in Western populations.

Conclusion Extraocular muscle insertion locations for the Taiwanese population in this study significantly differed from those reported in studies of Western populations. Therefore, surgical guidelines for performing lateral rectus recession to treat exotropia in Western populations may be inappropriate for Taiwanese and other Asian populations.

  • Extraocular muscle
  • strabismus surgery
  • ethnicity
  • vision
  • muscles
  • optic nerve
  • optics and refraction

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  • Funding This study was supported by Kaohsiung Medical University Hospital grant KMUH98-8G12.

  • Competing interests None.

  • Ethics approval This study was approved by the Institutional Review Board, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

  • Provenance and peer review Not commissioned; externally peer reviewed.