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Traumatic tear of the inferior rectus muscle treated with inferior oblique anterior transposition

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Abstract

Purpose

To report a case of traumatic tear of the inferior rectus muscle treated with inferior oblique anterior transposition (IOAT).

Methods

Case report of a 55-year-old man who presented with vertical diplopia (VD) after orbital trauma. Ocular examination disclosed a 62PD right hypertropia (RHT) in the primary position (PPO). The right inferior rectus (RIR) was torn, and the distal stump was fixed to the skin with tape.

Results

Surgery was performed under local anesthesia. The RIR tearing occurred 13 mm from the insertion, and exploration revealed its proximal end. The right inferior oblique (RIO) was intact, although its fibers were loose. Since the RHT did not improve following reattachment of the proximal and distal stumps of the RIR, the distal stump was excised and the proximal end brought forward and sutured 6.5 mm from the limbus. At perioperative evaluation, there was a 25PD RHT in PPO where the VD persisted. The RIO was subsequently isolated, detached, and its distal end, after 6 mm resection, was sutured to a point temporal to the lateral border of the RIR. The patient was reevaluated and had neither RHT nor VD in primary gaze. At the 6-week postoperative evaluation, he was orthotropic in PPO, complaining about diplopia only on extreme downgaze. A mild limitation of right depression was observed. The patient was satisfied with the surgical results and experienced no functional limitations during any activities.

Conclusion

IOAT can provide acceptable binocular visual function without the risk of anterior segment ischemia in cases of torn inferior rectus muscle.

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References

  1. MacEwen CJ, Lee JP, Fells P (1992) Etiology and management of the “detached” rectus muscle. Br J Ophthalmol 76:131–136

    PubMed  CAS  Google Scholar 

  2. Helveston EM, Grossman RD (1976) Extraocular muscle lacerations. Am J Ophthalmol 81:754–760

    PubMed  CAS  Google Scholar 

  3. Plager DA, Parks MM (1990) Recognition and repair of the “lost” rectus muscle. A report of 25 cases. Ophthalmology 97:131–136

    Google Scholar 

  4. Gonzales C, Klein B (1993) Myectomy and anterior transposition of the inferior oblique muscle: a new surgical procedure and its results in 49 operations. Binocul Vis 8:249–258

    Google Scholar 

  5. Goldchmit M, Feldeberg S, Souza-Dias C (2003) Unilateral anterior transposition of the inferior oblique muscle for correction of hypertropia in primary position. J AAPOS 7:241–243

    PubMed  Google Scholar 

  6. Seawright AA, Gole GG (1996) Results of the anterior transposition of the inferior oblique. Aust N Z J Ophthalmol 24:339–345

    PubMed  CAS  Google Scholar 

  7. Gonzales C, Cinciripini G (1995) Anterior transposition of the inferior oblique in the treatment of unilateral superior oblique palsy. J Pediatric Ophthalmol Strabismus 32:107–113

    Google Scholar 

  8. Elliott RL, Nankin SJ (1981) Anterior transposition of the inferior oblique. J Pediatr Ophthalmol Strabismus 18:35–38

    PubMed  CAS  Google Scholar 

  9. Olitsky SE, Notaro S (2000) Anterior transposition of the inferior oblique for the treatment of a “lost” inferior rectus muscle. J Pedriatr Ophthalmol Srabismus 37:50–51

    CAS  Google Scholar 

  10. Aguirre-Aquino BI, Rieman CD, Lewis H, Traboulsi EI (2001) Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle. J AAPOS 5:52–54

    PubMed  CAS  Google Scholar 

  11. Stager DR, Weakley DR, Stager D (1992) Anterior transposition of the inferior oblique. Arch Ophthalmol 110:360–362

    PubMed  CAS  Google Scholar 

  12. Stager DR (1997) The neurofibrovascular bundle of the inferior oblique muscle as the ancillary origin of that muscle. J AAPOS 1:216–225

    PubMed  CAS  Google Scholar 

  13. Kushner BJ (1997) Restriction of elevation in abduction after inferior oblique anteriorization. J AAPOS 1:55–561

    Article  PubMed  CAS  Google Scholar 

  14. Mims JL, Wood RC (1999) Antielevation syndrome after bilateral anterior transposition of the inferior oblique muscles: incidence and prevalence. J AAPOS 3:333–336

    PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Henry C. Witelson Ocular Pathology Laboratory, Department of Ophthalmology, McGill University, Lyman Duff Building, 3775 University Street, Room 216, Montreal, QC, Canada, H3A 2B4

    Katyanne Dantas Godeiro & Joao Pessoa Souza Filho

  2. Department of Ophthalmology, Federal University of São Paulo, Sao Paulo, Brazil

    Katyanne Dantas Godeiro, Anderson Gustavo Teixeira Pinto, Joao Pessoa Souza Filho & Celia Regina Nakanami

  3. Department of Ophthalmology, University of Mogi das Cruzes, Sao Paulo, Brazil

    Ana Maria Noriega Petrilli & Celia Regina Nakanami

Authors
  1. Katyanne Dantas Godeiro
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  2. Anderson Gustavo Teixeira Pinto
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  3. Joao Pessoa Souza Filho
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  4. Ana Maria Noriega Petrilli
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  5. Celia Regina Nakanami
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Corresponding author

Correspondence to Katyanne Dantas Godeiro.

Additional information

This work should be attributed to the University of Mogi das Cruzes.

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Godeiro, K.D., Pinto, A.G.T., Souza Filho, J.P. et al. Traumatic tear of the inferior rectus muscle treated with inferior oblique anterior transposition. Int Ophthalmol 26, 185–189 (2005). https://doi.org/10.1007/s10792-007-9035-z

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  • DOI: https://doi.org/10.1007/s10792-007-9035-z

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