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Quantitative measurement of passive duction force tension in intermittent exotropia and its clinical implications

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Abstract

Purpose

To evaluate the passive duction force (PDF) in extraocular muscles (EOMs) in patients with intermittent exotropia (IXT) using a quantitative tension-measuring device.

Methods

This prospective, case–control study enrolled 25 patients with IXT and 26 age- and sex-matched controls. PDF was measured under general anesthesia as the eyeball was rotated medially or laterally away from the direction of the force being tested. The preferred eye for fixation was determined using a cover–uncover test.

Results

The PDF in the IXT and control groups were 60.9 g and 52.1 g, respectively, for the lateral rectus (LR) (p = 0.046) and 53.0 g and 48.8 g for the medial rectus (MR) (p = 0.293). When the eyes were examined separately in the IXT group, the PDF of LR was larger in the nonpreferred eye for fixation than in the control group (p = 0.039), whereas there was no difference in the preferred eye for fixation (p = 0.216). Additionally, the relative PDF of LR in the nonpreferred eye compared to the ipsilateral PDF of MR was positively associated with the duration of manifest deviation (p = 0.042) and the average angle of the near and far deviations (p = 0.023).

Conclusions

The PDF in the LR in patients with IXT in the nonpreferred eye for fixation was larger than normal and could increase with the duration of manifest deviation and the angle of deviation. Evaluating the PDF in EOMs could provide information that is useful for managing strabismus and understanding its pathophysiology.

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Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2020R1I1A3075301). This sponsor had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Department of Mechatronics and Electronic Engineering, Konkuk University Glocal Campus, Chungju, Chungcheongbuk-do, Republic of Korea

    Hyunkyoo Kang

  2. Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea

    Shin-Hyo Lee

  3. Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul, South Korea

    Chung-Sik Oh

  4. Department of Ophthalmology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea

    Hyun Jin Shin

  5. Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA

    Hyun Jin Shin & Andrew G. Lee

  6. Department of Ophthalmology, Neurology, Neurosurgery, Weill Cornell Medicine, New York, NY, USA

    Andrew G. Lee

  7. Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA

    Andrew G. Lee

  8. Department of Ophthalmology, UT MD Anderson Cancer Center, Houston, TX, USA

    Andrew G. Lee

  9. Department of Ophthalmology, Texas A and M College of Medicine, College Station, TX, USA

    Andrew G. Lee

  10. Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Andrew G. Lee

  11. Department of Ophthalmology, Baylor College of Medicine and the Center for Space Medicine, Houston, TX, USA

    Andrew G. Lee

  12. Department of Ophthalmology, University of Buffalo, Buffalo, NY, USA

    Andrew G. Lee

Authors
  1. Hyunkyoo Kang
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  2. Shin-Hyo Lee
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  3. Chung-Sik Oh
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  4. Hyun Jin Shin
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  5. Andrew G. Lee
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Contributions

H.K. Kang developed the instrument and analyzed the data. S.H. Lee designed the study and illustrated figures. C. Oh designed the study and collect the data. H.J. Shin designed the study, collected the data, and wrote the manuscript. A.G. Lee revised the manuscript.

Corresponding author

Correspondence to Hyun Jin Shin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Review Board (IRB) of the Konkuk University Medical Center (registration number: KUH1100071).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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Kang, H., Lee, SH., Oh, CS. et al. Quantitative measurement of passive duction force tension in intermittent exotropia and its clinical implications. Graefes Arch Clin Exp Ophthalmol 259, 1617–1623 (2021). https://doi.org/10.1007/s00417-020-05030-x

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  • DOI: https://doi.org/10.1007/s00417-020-05030-x

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