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Surgical treatment of esotropia associated with high myopia: unilateral versus bilateral surgery.
MedLine Citation:
PMID:  20155708     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: To compare unilateral versus bilateral surgical treatment of esotropia associated with high myopia.
METHODS: This retrospective study comprised patients who underwent surgery for esotropia with high myopia performed by the first author (Y.M.) between 2003 and 2008. Surgical results and complications were compared between patients who underwent unilateral versus bilateral surgery.
RESULTS: Nine patients were identified with average age of 44.9 years (range 8-70 years). All had bilateral high myopia (average -13.35 D, range -9.00 to -17.50 D) and esotropia of 20-75 diopters, together with hypotropia in 5 cases. Bilateral displacement of the lateral rectus inferiorly and superior rectus medially was demonstrated in each patient by computed tomography scan of the orbits and by observation during surgery. Five patients underwent bilateral surgery and 4 underwent unilateral surgery. After an average follow-up of 29 months (range 4-47 months), 4/5 patients who underwent bilateral myopexy achieved good results with postoperative esotropia of less than 8 diopters, as opposed to 2/4 patients who underwent unilateral surgery. No complications were noted.
CONCLUSIONS: Bilateral superior and lateral rectus myopexy is the preferred method of surgical correction of esotropia associated with high myopia. Additional unilateral or bilateral medial rectus recession is probably not indicated in most cases. Patients who prefer unilateral surgery can benefit from unilateral superior and lateral rectus myopexy together with medial rectus recession. This unilateral approach may yield good results particularly in young patients without markedly restricted and tight extraocular muscles.
Authors:
Yair Morad; Eran Pras; Yakov Goldich; Yaniv Barkana; David Zadok; Morris Hartstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  20     ISSN:  1120-6721     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2011-05-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  653-8     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Assaf Harofeh Medical Center, Tel Aviv University, Zerifin, Israel.
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