Document Detail

Posterior fixation suture augmentation of full-tendon vertical rectus muscle transposition for abducens palsy.
MedLine Citation:
PMID:  10870927     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effect of augmenting full-tendon vertical rectus transpositions with posterior fixation sutures in patients with complete or near-complete lateral rectus palsy. METHODS: Transposition of the vertical recti to the lateral rectus muscle was performed in seven patients with unilateral lateral rectus palsy (the mean angle of preoperative horizontal deviation in primary gaze was 36.7 prism diopters (delta); range, 25-62delta of esotropia). A posterior fixation suture of 5.0 Mersilene (Ethicon, Somerville, NJ) was placed in sclera (14-16 mm posterior to the limbus) adjacent to the lateral rectus and incorporated 1/3 belly width of each transposed vertical rectus muscle. RESULTS: The mean angle of postoperative horizontal deviation in primary gaze was 7.1delta (range, 0-20delta). The mean change in primary-position horizontal deviation postoperatively was 41.2delta (range, 37-72delta). Four patients were able to fuse without prism in primary gaze; three patients were orthophoric and one patient had a consecutive intermittent exotropia. The remaining three patients required prism correction to neutralize the postoperative gaze deviation. All patients had improvement in abduction. Mild limitation of adduction was noted in three patients (range, -0.5 to -2.0). CONCLUSIONS: Augmenting full vertical rectus muscle transpositions with posterior fixation sutures improves the abducting effect of surgery without significant limitation of adduction.
B D Simons; R M Siatkowski; A G Neff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society     Volume:  20     ISSN:  1070-8022     ISO Abbreviation:  J Neuroophthalmol     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-09-28     Completed Date:  2000-09-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9431308     Medline TA:  J Neuroophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  119-22     Citation Subset:  IM    
Bascom Palmer Eye Institute, University of Miami, Florida, USA.
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MeSH Terms
Abducens Nerve Diseases / physiopathology,  surgery*
Aged, 80 and over
Eye Movements
Middle Aged
Ocular Motility Disorders / physiopathology,  surgery*
Oculomotor Muscles / physiopathology,  transplantation*
Sclera / surgery
Suture Techniques*
Tendon Transfer / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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