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Effects of oblique muscle surgery on the rectus muscle pulley

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To determine the position of rectus muscle pulleys in Japanese eyes and to evaluate the effect of oblique muscle surgery on rectus muscle pulleys.

Methods

Quasi-coronal plane MRI was used to determine area centroids of the 4 rectus muscles. The area centroids of the rectus muscles were transformed to 2-dimensional coordinates to represent pulley positions. The effects of oblique muscle surgery on the rectus muscle pulley positions in the coronal plane were evaluated in 10 subjects with cyclovertical strabismus and, as a control, pulley locations in 7 normal Japanese subjects were calculated.

Results

The mean positions of the rectus muscle pulleys in the coronal plane did not significantly differ from previous reports on normal populations, including Caucasians. There were significant positional shifts of the individual horizontal and vertical rectus muscle pulleys in 3 (100%) patients with inferior oblique advancement, but not in eyes with inferior oblique recession and superior oblique tendon advancement surgery. The surgical cyclorotatory effect was significantly correlated with the change in the angle of inclination formed by the line connecting the vertical rectus muscles (p = 0.0234), but weakly correlated with that of the horizontal rectus muscles.

Conclusions

The most important factor that affects the pulley position is the amount of ocular torsion, not the difference in surgical procedure induced by oblique muscle surgery.

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Acknowledgments

This study was supported in part by a Grant-in-Aid (20592044 and 22591964) from the Ministry of Education, Science, Sports, and Culture of Japan in Japan. The authors thank Kazushi Kinugasa, Director of the National Agency for Automotive Safety and Victims’ Aid, Okayama Ryogo Center, Okayama, Japan, who provided the MRI facility and equipment. We express our deep gratitude to Professor Joseph L. Demer of the Jules Stein Eye Institute, University of California, Los Angeles, USA, for valuable advice and comments on the manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama, Okayama, 700-8558, Japan

    Hirotaka Okanobu, Reika Kono & Hiroshi Ohtsuki

Authors
  1. Hirotaka Okanobu
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  2. Reika Kono
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  3. Hiroshi Ohtsuki
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Corresponding author

Correspondence to Reika Kono.

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Okanobu, H., Kono, R. & Ohtsuki, H. Effects of oblique muscle surgery on the rectus muscle pulley. Jpn J Ophthalmol 55, 514–524 (2011). https://doi.org/10.1007/s10384-011-0051-1

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  • DOI: https://doi.org/10.1007/s10384-011-0051-1

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