Journalartikel

Splitting of the lateral rectus muscle with medial transposition to treat oculomotor palsy: a retrospective analysis of 29 consecutive cases


AutorenlisteBasiakos, Sotirios; Graef, Michael; Preising, Markus N.; Lorenz, Birgit

Jahr der Veröffentlichung2019

Seiten2005-2014

ZeitschriftGraefe's Archive for Clinical and Experimental Ophthalmology

Bandnummer257

Heftnummer9

ISSN0721-832X

eISSN1435-702X

DOI Linkhttps://doi.org/10.1007/s00417-019-04370-7

VerlagSpringer


Abstract
Purpose The lateralis splitting technique has been an interesting option for treating large-angle exotropia due to complete 3rd nerve paralysis since its inception in the early 1990s. The purpose of this study is to report on our experience regarding the effectiveness and complications of this method. Methods Retrospective analysis of a consecutive series of 29 patients operated by one single experienced surgeon and examined according to a specific operative and perioperative protocol. Patients were examined preoperatively, on the 2nd day and 3rd month after surgery. Outcome measures include strabismus angle, horizontal motility, head turn, binocular function, and incidence and resolution of postoperative serous retinal detachment as seen with infrared imaging and spectral domain optical coherence tomography (SD-OCT). Results Surgery brought about a large and stable reduction of strabismus angle and head turn. It reduced horizontal motility, but moved the range of monocular excursion much closer to center. Eighty percent of patients with constant diplopia acquired some fields of single binocular vision. A significant number of cases (33.3%) developed transitory serous retinal detachment with varying onset and extent. Conclusion This is by far the largest published study regarding the outcome of lateralis splitting in NIII palsy. The procedure is difficult, yet a very useful option. Serous detachment is a serious complication, but usually transitory. Its cause and mechanisms are not fully understood and warrant further investigation.



Zitierstile

Harvard-ZitierstilBasiakos, S., Graef, M., Preising, M. and Lorenz, B. (2019) Splitting of the lateral rectus muscle with medial transposition to treat oculomotor palsy: a retrospective analysis of 29 consecutive cases, Graefe's Archive for Clinical and Experimental Ophthalmology, 257(9), pp. 2005-2014. https://doi.org/10.1007/s00417-019-04370-7

APA-ZitierstilBasiakos, S., Graef, M., Preising, M., & Lorenz, B. (2019). Splitting of the lateral rectus muscle with medial transposition to treat oculomotor palsy: a retrospective analysis of 29 consecutive cases. Graefe's Archive for Clinical and Experimental Ophthalmology. 257(9), 2005-2014. https://doi.org/10.1007/s00417-019-04370-7



Schlagwörter


Lateral rectus nasal transpositionLateral rectus splittingNERVE PALSYparalysisParalytic strabismusSUTURESThird nerve palsy


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