Function of transected or avulsed rectus muscles following recovery using an anterior orbitotomy approach.

Journal Article (Journal Article)

PURPOSE: To assess the function of muscles retrieved from a retrobulbar location using an anterior orbitotomy approach and to identify the prognostic factors favoring a good outcome. METHODS: The records of all patients undergoing anterior orbitotomy for the retrieval of a transected or avulsed muscle in a retrobulbar location were reviewed. Ocular motility, before and after retrieval (with ductions scaled from -4 to +4), was evaluated. RESULTS: Record review identified 11 patients who had suffered trauma to 12 muscles (5 inferior, 6 medial, and 1 lateral rectus muscle). Ductions improved from -4 ± 0.4 preoperatively to -2.7 ± 0.9 postoperatively (P = 0.002); mean primary position deviation improved from 34(Δ) ± 14(Δ)-15(Δ) ± 9(Δ) (P < 0.001), and mean deviation in the field of action improved from 47(Δ) ± 20(Δ)-20(Δ) ± 22(Δ) (P = 0.02). Ductions improved by at least two units in three patients, all of whom had medial rectus trauma. Single binocular vision in primary gaze was achieved in 6 patients. Patients with medial rectus muscle injury and patients injured by sinus surgery had the lowest likelihood of recovering single binocular vision. CONCLUSIONS: Our results are similar to historical series in which muscles were not retrieved and transpositions performed; however, muscle retrieval avoids risks associated with transposition surgeries such as anterior segment ischemia. Muscle recovery via the anterior orbitotomy approach may be reasonable to consider in those cases with a reasonable possibility of having active force generation postoperatively.

Full Text

Duke Authors

Cited Authors

  • Pineles, SL; Laursen, J; Goldberg, RA; Demer, JL; Velez, FG

Published Date

  • August 2012

Published In

Volume / Issue

  • 16 / 4

Start / End Page

  • 336 - 341

PubMed ID

  • 22835914

Pubmed Central ID

  • PMC3597083

Electronic International Standard Serial Number (EISSN)

  • 1528-3933

Digital Object Identifier (DOI)

  • 10.1016/j.jaapos.2012.03.001


  • eng

Conference Location

  • United States