Special consideration while planning exotropia surgery in high myopic adults
Aim To follow a new parameter in managing exotropia in high myopic adults. Patients and methods This study included 30 adult patients, having high myopia, more than −8 D in one or both eyes, and suffering from exotropia. The exotropia is investigated, whether axial or curvature, by measuring the axi...
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| Language: | English |
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Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Journal of the Egyptian Ophthalmological Society |
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| Online Access: | https://journals.lww.com/10.4103/ejos.ejos_45_24 |
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| author | Karim Gaballah Dalal Shawky |
| author_facet | Karim Gaballah Dalal Shawky |
| author_sort | Karim Gaballah |
| collection | DOAJ |
| description | Aim
To follow a new parameter in managing exotropia in high myopic adults.
Patients and methods
This study included 30 adult patients, having high myopia, more than −8 D in one or both eyes, and suffering from exotropia.
The exotropia is investigated, whether axial or curvature, by measuring the axial length in both eyes, and studying the corneal curvature, and the angle of exotropia was measured for distance and for near. In this study, after excluding restrictive strabismus, the largest angle of exotropia, is targeted, but the choice of surgery was always plication of medial recti muscles, whether one or two depending on the angle to be corrected and the eye with exotropia, avoiding recession of lateral recti, even if divergence excess, so avoid postoperative bad cosmesis that results from muscle recession, causing some proptosis and widening of palpebral fissures which are not satisfying to the patients, keeping recession of lateral recti for residual exotropia after plication of medial recti.
Results
Exotropia was corrected in all cases, without postoperative widening of the palpebral fissure height, by using the medial rectus muscle plication for strengthening the medial recti muscles. Two cases of residual exotropia required a second surgery, lateral rectus weakening, performed by hang back technique, avoiding accidental scleral path.
Conclusion
Strengthening of the medial recti muscles in high myopic exotropic patients was found to be a surgical technique without the known complication of postoperative widening of vertical palpebral fissure height and also without any problem of intrascleral path that could happen when recessing lateral recti muscles in high mopes with thin sclera. |
| format | Article |
| id | doaj-art-bf96b00a293441e2b211cab110af97b2 |
| institution | OA Journals |
| issn | 2090-0686 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of the Egyptian Ophthalmological Society |
| spelling | doaj-art-bf96b00a293441e2b211cab110af97b22025-08-20T02:28:32ZengWolters Kluwer Medknow PublicationsJournal of the Egyptian Ophthalmological Society2090-06862025-04-01118216717410.4103/ejos.ejos_45_24Special consideration while planning exotropia surgery in high myopic adultsKarim GaballahDalal ShawkyAim To follow a new parameter in managing exotropia in high myopic adults. Patients and methods This study included 30 adult patients, having high myopia, more than −8 D in one or both eyes, and suffering from exotropia. The exotropia is investigated, whether axial or curvature, by measuring the axial length in both eyes, and studying the corneal curvature, and the angle of exotropia was measured for distance and for near. In this study, after excluding restrictive strabismus, the largest angle of exotropia, is targeted, but the choice of surgery was always plication of medial recti muscles, whether one or two depending on the angle to be corrected and the eye with exotropia, avoiding recession of lateral recti, even if divergence excess, so avoid postoperative bad cosmesis that results from muscle recession, causing some proptosis and widening of palpebral fissures which are not satisfying to the patients, keeping recession of lateral recti for residual exotropia after plication of medial recti. Results Exotropia was corrected in all cases, without postoperative widening of the palpebral fissure height, by using the medial rectus muscle plication for strengthening the medial recti muscles. Two cases of residual exotropia required a second surgery, lateral rectus weakening, performed by hang back technique, avoiding accidental scleral path. Conclusion Strengthening of the medial recti muscles in high myopic exotropic patients was found to be a surgical technique without the known complication of postoperative widening of vertical palpebral fissure height and also without any problem of intrascleral path that could happen when recessing lateral recti muscles in high mopes with thin sclera.https://journals.lww.com/10.4103/ejos.ejos_45_24exotropiahigh myopic adultsmedial recti plicationpalpebral fissure height |
| spellingShingle | Karim Gaballah Dalal Shawky Special consideration while planning exotropia surgery in high myopic adults Journal of the Egyptian Ophthalmological Society exotropia high myopic adults medial recti plication palpebral fissure height |
| title | Special consideration while planning exotropia surgery in high myopic adults |
| title_full | Special consideration while planning exotropia surgery in high myopic adults |
| title_fullStr | Special consideration while planning exotropia surgery in high myopic adults |
| title_full_unstemmed | Special consideration while planning exotropia surgery in high myopic adults |
| title_short | Special consideration while planning exotropia surgery in high myopic adults |
| title_sort | special consideration while planning exotropia surgery in high myopic adults |
| topic | exotropia high myopic adults medial recti plication palpebral fissure height |
| url | https://journals.lww.com/10.4103/ejos.ejos_45_24 |
| work_keys_str_mv | AT karimgaballah specialconsiderationwhileplanningexotropiasurgeryinhighmyopicadults AT dalalshawky specialconsiderationwhileplanningexotropiasurgeryinhighmyopicadults |