Abstract
Purpose :
To report our findings that new insertion sites of horizontal extrocular muscle (EOM) are anteriorly located than expected location after large-dose EOM recession in patients with nystagmus.
Methods :
We had total 18 cases that needed re-operation after large-dose horizontal EOM recession for their nystagmus. The mean age were 10.4±8.1 years. Four cases were reoperated due to unsatisfied nystagmus reduction, two cases were due to secondary esotropia and 12 cases ware due to secondary extropia. Their horizontal EOMs were sutured to the sclera 4-5 mm behind the original insertion and 8 mm hang-back suspension for medial recti, and 8 mm behind the original insertion and 8-9 mm hang-back suspension for lateral recti. Their second surgeries were performed 6-24 months after their first operations.
Results :
We observed during their second operation that new insertions of the horizontal EOMs were located to the sites where sclera sutures were put, which was far anterior to the expected sites.
Conclusions :
The findings of anteriorly located new insertion of horizontal EOMs after large-dose recessions indicate that the amount of EOM contraction is limited. They may suggest that oculomotor adaptation may not be blamed for the relapse of nystagmus. Finally, it may suggest an improvement of nystagmus surgery. Such as, to obtain enough recessions of EOMs for the procedure of large-dose of EOM recessions, it may be necessary to resect an amount of EOM first
This is a 2020 ARVO Annual Meeting abstract.