Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia

Heba M Shafik, Mohamed Ashraf Eldesouky, Dina Tadros Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Heba M ShafikTanta University Hospital, El-Geish Street, Tanta, EgyptTel +00201227440829Fax +0020403274005Email drhebash81@gmail.comPurpose: To evaluat...

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Autores principales:	Shafik HM, Eldesouky MA, Tadros D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	sensory exotropia autograft lateral rectus elongation Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/669153b265a44ee09add5a6b591a4b9a
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spelling	oai:doaj.org-article:669153b265a44ee09add5a6b591a4b9a2021-12-02T12:55:43ZLateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia1177-5483https://doaj.org/article/669153b265a44ee09add5a6b591a4b9a2020-07-01T00:00:00Zhttps://www.dovepress.com/lateral-rectus-muscle-tendon-elongation-by-an-auto-graft-from-the-rese-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Heba M Shafik, Mohamed Ashraf Eldesouky, Dina Tadros Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Heba M ShafikTanta University Hospital, El-Geish Street, Tanta, EgyptTel +00201227440829Fax +0020403274005Email drhebash81@gmail.comPurpose: To evaluate using the resected medial rectus muscle for elongation of the lateral rectus tendon in monocular surgery for large-angle sensory exotropia.Patients and Methods: A prospective case series was carried out in Tanta University hospital from January 2017 to June 2018 including 16 patients with large-angle sensory exotropia ≥ 50PD. The near and distance angles of exotropia were measured; any restrictions in adduction or abduction were recorded and scaled from − 4 to 0. Resection of the medial rectus muscle was done first; the resected segment was attached to the lateral rectus muscle after dissection by mattress sutures, and the muscle was recessed after elongation according to the preoperative distance angles. Successful motor alignment was considered if the angle measurement was within 10 PD of orthotropia at distance after 6 months. The stability of the alignment, any motility restrictions, and patient satisfaction were recorded at each follow-up visit until the 6th month.Results: The mean age of the study patients was 30.68± 13.30 years. The best-corrected visual acuity of the exotropic eyes by logMAR was 1.2± 0.3; the mean of the preoperative distance angle of deviation was − 72.19 ± 14.26 PD. The mean preoperative adduction and abduction restrictions were − 1.19 ± 1.52 and − 1.13 ± 1.09, respectively. There was significant improvement in the distance angle of deviation at the last follow-up after 6 months (p=0.001*). Also, there was improvement in both adduction and abduction restriction from the first to last follow-up. Thirteen patients (81.2%) were satisfied at the 6-month follow-up.Conclusion: Elongation of the lateral rectus muscle by an autograft from the resected medial rectus muscle is an easy, effective procedure for large-angle sensory exotropia. Patients achieve good postoperative alignment with minimal restriction of ocular motility.Keywords: sensory exotropia, autograft, lateral rectus elongationShafik HMEldesouky MATadros DDove Medical Pressarticlesensory exotropia autograft lateral rectus elongationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2135-2142 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	sensory exotropia autograft lateral rectus elongation Ophthalmology RE1-994
spellingShingle	sensory exotropia autograft lateral rectus elongation Ophthalmology RE1-994 Shafik HM Eldesouky MA Tadros D Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
description	Heba M Shafik, Mohamed Ashraf Eldesouky, Dina Tadros Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Heba M ShafikTanta University Hospital, El-Geish Street, Tanta, EgyptTel +00201227440829Fax +0020403274005Email drhebash81@gmail.comPurpose: To evaluate using the resected medial rectus muscle for elongation of the lateral rectus tendon in monocular surgery for large-angle sensory exotropia.Patients and Methods: A prospective case series was carried out in Tanta University hospital from January 2017 to June 2018 including 16 patients with large-angle sensory exotropia ≥ 50PD. The near and distance angles of exotropia were measured; any restrictions in adduction or abduction were recorded and scaled from − 4 to 0. Resection of the medial rectus muscle was done first; the resected segment was attached to the lateral rectus muscle after dissection by mattress sutures, and the muscle was recessed after elongation according to the preoperative distance angles. Successful motor alignment was considered if the angle measurement was within 10 PD of orthotropia at distance after 6 months. The stability of the alignment, any motility restrictions, and patient satisfaction were recorded at each follow-up visit until the 6th month.Results: The mean age of the study patients was 30.68± 13.30 years. The best-corrected visual acuity of the exotropic eyes by logMAR was 1.2± 0.3; the mean of the preoperative distance angle of deviation was − 72.19 ± 14.26 PD. The mean preoperative adduction and abduction restrictions were − 1.19 ± 1.52 and − 1.13 ± 1.09, respectively. There was significant improvement in the distance angle of deviation at the last follow-up after 6 months (p=0.001*). Also, there was improvement in both adduction and abduction restriction from the first to last follow-up. Thirteen patients (81.2%) were satisfied at the 6-month follow-up.Conclusion: Elongation of the lateral rectus muscle by an autograft from the resected medial rectus muscle is an easy, effective procedure for large-angle sensory exotropia. Patients achieve good postoperative alignment with minimal restriction of ocular motility.Keywords: sensory exotropia, autograft, lateral rectus elongation
format	article
author	Shafik HM Eldesouky MA Tadros D
author_facet	Shafik HM Eldesouky MA Tadros D
author_sort	Shafik HM
title	Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_short	Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_full	Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_fullStr	Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_full_unstemmed	Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia
title_sort	lateral rectus muscle tendon elongation by an auto graft from the resected medial rectus muscle as a monocular surgery for large-angle sensory exotropia
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/669153b265a44ee09add5a6b591a4b9a
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Lateral Rectus Muscle Tendon Elongation by an Auto Graft from the Resected Medial Rectus Muscle as a Monocular Surgery for Large-Angle Sensory Exotropia

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