RT Journal Article
SR Electronic
T1 Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 983
OP 985
DO 10.1136/bjo.2004.051219
VO 89
IS 8
A1 Y Morad
A1 L Kowal
A1 A B Scott
YR 2005
UL http://bjo.bmj.com/content/89/8/983.abstract
AB Background/aims: Surgical correction of ocular alignment in patients with third cranial nerve paralysis is challenging, as the unopposed lateral rectus muscle often pulls the eye back to exotropia following surgery. The authors present a simple surgical approach to overcome this difficulty. This approach is also applicable to removal of unwanted overactivity of the lateral rectus in Duane syndrome. Methods: A review was made of the records of four patients with third cranial nerve paralysis and one with Duane syndrome with exotropia in which the lateral rectus muscle was removed from its scleral insertion and reattached to the orbital wall. Additional surgery to bring the eye to the midline included medial rectus resection, medial transposition of the vertical recti, and passive suturing of the eye to the medial orbit wall. Results: All patients achieved satisfactory ocular alignment following surgery. Ocular ductions were limited. These results were stable for 1.5–4 years of follow up. No major complications occurred. Conclusion: Lateral rectus muscle disinsertion and reattachment to the orbital wall to absorb its force and thus remove abduction torque was a simple and safe surgical procedure for restoring ocular alignment in four patients with third cranial nerve paralysis and in one patient with Duane syndrome with severe exotropia.