Journal article
Authors list: Oke, Isdin; Lorenz, Birgit; Basiakos, Sotirios; Gokyigit, Birsen; Dodd, Mary-Magdalene Ugo; Laurent, Erick; Hunter, David G.; Goberville, Mitra; Elkamshoushy, Amr; Tsai, Chong-bin; Orge, Faruk; Velez, Federico G.; Jeddawi, Laila; Gravier, Nicholas; Li, Ningdong; Shah, Ankoor S.; Dagi, Linda R.
Publication year: 2022
Pages: 165-172
Journal: American Journal of Ophthalmology
Volume number: 242
ISSN: 0002-9394
eISSN: 1879-1891
DOI Link: https://doi.org/10.1016/j.ajo.2022.06.010
Publisher: Elsevier
Abstract:
PURPOSE: To determine the success rate and compli-cations associated with nasal transposition of the split lateral rectus muscle (NTSLR) for treating bilateral 3rd -nerve palsy.DESIGN: Retrospective, interventional case series.METHODS: An international, multicenter registry was used for the study. The study population was all pa-tients with bilateral 3rd-nerve palsy treated with NTSLR. Sensorimotor evaluations were conducted before and 6 months after unilateral or bilateral NTSLR. Outcome measures were postoperative horizontal alignment <15 prism diopters (PD), intraoperative technical difficulties, and vision-threatening complications. The association of patient demographics and surgical technique with each outcome was analyzed using multivariable logistic regres-sion.RESULTS: A total of 34 patients were included, with a median age of 46 years (interquartile range [IQR] = 25 -54 years) at surgery. The most common etiologies were is-chemic (29%), neoplastic (15%), and congenital (12%). NTSLR performed unilaterally with alternative surgery on the opposite eye (65%) resulted in a median postop-erative exotropia of 18 PD (IQR = 7-35 PD), and when performed bilaterally (35%) resulted in postoperative ex-otropia of 14 PD (IQR = 5-35 PD). Success was achieved in 50% of cases, intraoperative technical difficulties were reported in 18%, and vision-threatening complications occurred in 21%. Attachment of the lateral rectus muscle >10 mm posterior to the medial rectus insertion was as-sociated with increased vision-threatening complications (odds ratio = 9.0; 95% CI = 1.3-99).CONCLUSIONS: NTSLR can address the large-angle exotropia associated with bilateral 3rd-nerve palsy. Sur-geons should be aware that posterior placement of the lateral rectus muscle may increase the risk of vision -threatening complications, particularly serous choroidal effusion.
Citation Styles
Harvard Citation style: Oke, I., Lorenz, B., Basiakos, S., Gokyigit, B., Dodd, M., Laurent, E., et al. (2022) Nasal Transposition of the Split Lateral Rectus Muscle for Strabismus Associated With Bilateral 3rd-Nerve Palsy, American Journal of Ophthalmology, 242, pp. 165-172. https://doi.org/10.1016/j.ajo.2022.06.010
APA Citation style: Oke, I., Lorenz, B., Basiakos, S., Gokyigit, B., Dodd, M., Laurent, E., Hunter, D., Goberville, M., Elkamshoushy, A., Tsai, C., Orge, F., Velez, F., Jeddawi, L., Gravier, N., Li, N., Shah, A., & Dagi, L. (2022). Nasal Transposition of the Split Lateral Rectus Muscle for Strabismus Associated With Bilateral 3rd-Nerve Palsy. American Journal of Ophthalmology. 242, 165-172. https://doi.org/10.1016/j.ajo.2022.06.010
Keywords
MEDIAL TRANSPOSITION; OCULOMOTOR NERVE PALSY
