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International Ophthalmology

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01-02-2020 | Original Paper

Vertical rectus muscle union combined with lateral rectus plication for complete abducens nerve palsy

Authors: Asli Inal, Birsen Gokyigit, Osman Bulut Ocak, Ebru Demet Aygit, Selcen Celik

Published in: International Ophthalmology | Issue 2/2020

Abstract

Purpose

The aim of this study was to report our postoperative results concerning the vertical rectus (VR) muscle union combined with lateral rectus (LR) plication for the treatment of large-angle esotropia (ET) in complete abducens nerve palsy.

Methods

Medical records from 36 patients who had undergone the VR union procedure for ET treatment due to sixth-nerve palsy between July 2014 and July 2018 at Beyoglu Eye Research and Training Hospital were reviewed. One week before surgery, all patients underwent a 4-IU botulinum toxin A (btx) injection into the ipsilateral medial rectus (MR). All patients then underwent a VR muscle union procedure. A non-absorbable suture was inserted through the lateral muscular margin of each VR muscle at approximately 1/5 the width from the edge at 10 mm distance from the VR insertion. Both sutures were then tied to each other above the LR. Plication of the LR muscle using a non-absorbable suture was performed in all cases.

Results

The study population consisted of 14 (38.9%) females and 22 (61.1%) males. The mean age was 36.31 ± 19.16 years. The mean preoperative deviation angle in primary gaze into distance was 47.77 ± 18.48 prism diopter (PD). The mean deviation angle 1 year after surgery was − 1.0 ± 6.62 PD. Abduction improved from − 4.27 ± 0.46 to − 1.88 ± 0.96.

Conclusion

The VR muscle union in combination with LR plication appears to be an effective treatment procedure for complete abducens nerve palsy patients.

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Title: Vertical rectus muscle union combined with lateral rectus plication for complete abducens nerve palsy
Authors: Asli Inal
Birsen Gokyigit
Osman Bulut Ocak
Ebru Demet Aygit
Selcen Celik
Publication date: 01-02-2020
Publisher: Springer Netherlands
Published in: International Ophthalmology / Issue 2/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-019-01200-x

At a glance: The STEP trials

Springer Medicine

Vertical rectus muscle union combined with lateral rectus plication for complete abducens nerve palsy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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