Revision operations after tenotomy of the medial rectus muscle

Klinische Monatsblätter für Augenheilkunde
T KrzizokM Kött

Abstract

Although tenotomy of the medial rectus (MR) is generally regarded to be obsolete, consecutive exotropia after this procedure, requiring a reoperation, still occurs. In 143 patients a reoperation after tenotomy of the MR had to be performed because of consecutive exotropia. Either only the MR was sutured at the original insertion (advancement; this constitutes group 1, n = 101) or the lateral rectus (LR) was recessed in addition (group 2, n = 12). The recession of the LR was only added if the adduction was not distinctly limited and if the distance of the MR from the limbus was less than 16 mm. We wanted to find out whether the procedure in group 1 or 2 gave the better results. In group 1 the muscle sheath of the MR was found at a distance of 7 mm (median), the muscle itself at a distance of 18 mm from the limbus (confidence interval 13.5-25 mm). In group 2 the distance of the muscle sheath from the limbus was similar to group 1, the muscle itself was found already at a distance of 12 mm from the limbus (confidence interval 6-18 mm). After reinsertion of the muscle at the original insertion without recession of the LR, a distinct limitation of abduction combined with a globe retraction was seen immediately after surgery. A spont...Continue Reading

Citations

Apr 9, 2005·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·A LangmannR Hörantner

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