July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Extraocular Muscles Insertion Analysis Using Ultrasound Biomicroscopy and Anterior Segment Optical Coherence Tomography and Intraoperative Correlation in Adult Patients with Strabismus After Trauma
Author Affiliations & Notes
  • Astrid Enid Gonzalez Ramos
    Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, United States
  • Natalia Cintron
    Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, United States
  • Marino Blasini Torres
    Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, United States
  • Rene Vazquez Botet
    Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, United States
  • Footnotes
    Commercial Relationships   Astrid Gonzalez Ramos, None; Natalia Cintron, None; Marino Blasini Torres, None; Rene Vazquez Botet, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1028. doi:
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      Astrid Enid Gonzalez Ramos, Natalia Cintron, Marino Blasini Torres, Rene Vazquez Botet; Extraocular Muscles Insertion Analysis Using Ultrasound Biomicroscopy and Anterior Segment Optical Coherence Tomography and Intraoperative Correlation in Adult Patients with Strabismus After Trauma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1028.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There is limited knowledge regarding how to adequately plan a strabismus surgery on a patient with disinserted extra ocular muscle (EOM) due to trauma. We performed a prospective case series to test the hypothesis that ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) can be used to assess EOM new attachment sites prior to strabismus surgery in patients with EOM disinsertion after trauma.

Methods : Two cases of adult male patients with post traumatic strabismus were included in this study. AS-OCT (Heidenberg-Spectralis) and UBM (Aviso-Quantel Medical) were used to analyze the injured extra ocular muscle new attachment site from limbus before surgery. The contralateral eye was used as a control for each patient respectively. Intraoperative EOM insertion measurement was taken using a surgical caliper. Comparison of pre-operative and intra-operative measurements was done.

Results : Case 1: 43-year-old Hispanic male with traumatic disinsertion of medial rectus muscle. Preoperative measurement of insertion using UBM was 10.65mm. Intraoperative measured insertion was 10mm with caliper.

Case 2: 57-year-old Hispanic male with traumatic disinsertion of inferior rectus muscle. Preoperative insertion measurement with UBM was 8.40mm. Intraoperative insertion was 9.00mm with caliper.

Insertions of extraocular muscles with Heidenberg-Spectralis AS-OCT could not be successfully analyzed due to limitation of image capture area by AS-OCT camera used.

Conclusions : Although Heidenberg-Spectralis AS-OCT can’t be adequately used for our study’s purpose we have found that UBM serve as an efficient tool for pre-operative strabismus surgical planning, especially in patients with history of EOM disinsertion by trauma. Using this imaging technique, we can anticipate surgical scenarios, and consequently decrease morbidity by reducing time under anesthesia of both adult and pediatric population. This will result in superior post-surgical outcomes.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Case 1: UBM image of displaced medial rectus muscle insertion from limbus, 10.65mm

Case 1: UBM image of displaced medial rectus muscle insertion from limbus, 10.65mm

 

Case 2: UBM image of displaced inferior rectus muscle from limbus, 8.40mm

Case 2: UBM image of displaced inferior rectus muscle from limbus, 8.40mm

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