Reoperation of Highly Myopic Strabismus by Surgical Procedure Joining the Lateral Rectus and Superior Rectus Muscles

Abstract

Objective To evaluate the effect of surgical procedure joining the lateral rectus and superior rectus muscles in the reoperation of highly myopic strabismus who failed to conventional surgery. Methods From September 2012 to December 2017, 5 patients (8 eyes), 2 males (4 eyes) and 3 females (4 eyes), aged 52.0-73.0 years, with an average of (61.2±2.4) with high myopia restricted esotropia who had undergone strabismus correction again at Xiamen Ophthalmological Center affiliated to Xiamen University due to ineffective conventional retraction surgery were collected. Year old. Before and after surgery, all patients underwent visual acuity, refraction, slit lamp microscopy, fundus, eye movement, oblique angle, axial length, coronal and horizontal computed tomography (CT) examination. Partial ligation of lateral rectus and superior rectus was performed. Results 5 cases (8 eyes) were in the inferior oblique position with limited external and upward rotation. CT showed that the superior rectus muscle shifted to the nasal side, the lateral rectus muscle moved downward, and the posterior part of the eyeball herniated to the superior temporal muscle cone. 2 cases (4 eyes) underwent partial ligation of lateral rectus and superior rectus, 1 case (2 eyes) underwent partial ligation of lateral rectus and superior rectus combined with recession suspension of medial rectus, and 2 cases (2 eyes) underwent partial ligation of lateral rectus and superior rectus. At the follow-up of more than 6 months, 4 cases (6 eyes) were in the first eye position after operation, and 1 case (2 eyes) had the first eye position of -15°in the long term. CT showed that the dislocated eye was returned to the conus muscularis, and the function of the external and upward rotation of the eye gradually recovered. No diplopia occurred in all patients. No complications occurred. Conclusions Surgical procedure joining the lateral rectus and superior rectus muscles can effectively correct highly myopic strabismus which is ineffective after conventional surgery. It can also restore the dislocated globe back into the muscle cone and improve the function of eye movement. Key words: Strabismus; Myopia; Surgical procedure