Abstract
Purpose
To report a case of traumatic tear of the inferior rectus muscle treated with inferior oblique anterior transposition (IOAT).
Methods
Case report of a 55-year-old man who presented with vertical diplopia (VD) after orbital trauma. Ocular examination disclosed a 62PD right hypertropia (RHT) in the primary position (PPO). The right inferior rectus (RIR) was torn, and the distal stump was fixed to the skin with tape.
Results
Surgery was performed under local anesthesia. The RIR tearing occurred 13 mm from the insertion, and exploration revealed its proximal end. The right inferior oblique (RIO) was intact, although its fibers were loose. Since the RHT did not improve following reattachment of the proximal and distal stumps of the RIR, the distal stump was excised and the proximal end brought forward and sutured 6.5 mm from the limbus. At perioperative evaluation, there was a 25PD RHT in PPO where the VD persisted. The RIO was subsequently isolated, detached, and its distal end, after 6 mm resection, was sutured to a point temporal to the lateral border of the RIR. The patient was reevaluated and had neither RHT nor VD in primary gaze. At the 6-week postoperative evaluation, he was orthotropic in PPO, complaining about diplopia only on extreme downgaze. A mild limitation of right depression was observed. The patient was satisfied with the surgical results and experienced no functional limitations during any activities.
Conclusion
IOAT can provide acceptable binocular visual function without the risk of anterior segment ischemia in cases of torn inferior rectus muscle.
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References
MacEwen CJ, Lee JP, Fells P (1992) Etiology and management of the “detached” rectus muscle. Br J Ophthalmol 76:131–136
Helveston EM, Grossman RD (1976) Extraocular muscle lacerations. Am J Ophthalmol 81:754–760
Plager DA, Parks MM (1990) Recognition and repair of the “lost” rectus muscle. A report of 25 cases. Ophthalmology 97:131–136
Gonzales C, Klein B (1993) Myectomy and anterior transposition of the inferior oblique muscle: a new surgical procedure and its results in 49 operations. Binocul Vis 8:249–258
Goldchmit M, Feldeberg S, Souza-Dias C (2003) Unilateral anterior transposition of the inferior oblique muscle for correction of hypertropia in primary position. J AAPOS 7:241–243
Seawright AA, Gole GG (1996) Results of the anterior transposition of the inferior oblique. Aust N Z J Ophthalmol 24:339–345
Gonzales C, Cinciripini G (1995) Anterior transposition of the inferior oblique in the treatment of unilateral superior oblique palsy. J Pediatric Ophthalmol Strabismus 32:107–113
Elliott RL, Nankin SJ (1981) Anterior transposition of the inferior oblique. J Pediatr Ophthalmol Strabismus 18:35–38
Olitsky SE, Notaro S (2000) Anterior transposition of the inferior oblique for the treatment of a “lost” inferior rectus muscle. J Pedriatr Ophthalmol Srabismus 37:50–51
Aguirre-Aquino BI, Rieman CD, Lewis H, Traboulsi EI (2001) Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle. J AAPOS 5:52–54
Stager DR, Weakley DR, Stager D (1992) Anterior transposition of the inferior oblique. Arch Ophthalmol 110:360–362
Stager DR (1997) The neurofibrovascular bundle of the inferior oblique muscle as the ancillary origin of that muscle. J AAPOS 1:216–225
Kushner BJ (1997) Restriction of elevation in abduction after inferior oblique anteriorization. J AAPOS 1:55–561
Mims JL, Wood RC (1999) Antielevation syndrome after bilateral anterior transposition of the inferior oblique muscles: incidence and prevalence. J AAPOS 3:333–336
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This work should be attributed to the University of Mogi das Cruzes.
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Godeiro, K.D., Pinto, A.G.T., Souza Filho, J.P. et al. Traumatic tear of the inferior rectus muscle treated with inferior oblique anterior transposition. Int Ophthalmol 26, 185–189 (2005). https://doi.org/10.1007/s10792-007-9035-z
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DOI: https://doi.org/10.1007/s10792-007-9035-z