Eyelid Fissure Narrowing after Recession of the Medial Rectus Muscle

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DOI: 10.4236/ss.2011.27082   PDF   HTML     4,245 Downloads   6,395 Views  

Abstract

A 67-year-old male had suffered from eye movement disturbance from Graves’ orbitopathy. His right eye was fixed in an esotropic position. Examination by synoptophore showed that his right eye deviation was 22 degrees medially. The upper eyelid margin reflex distance (MRD) was 3.5 mm OD and 5.6 mm OS, and the lower eyelid MRD was 5.1 mm OU. Six mm medial rectus muscle recession with tenotomy was performed in the patient. The next day after the surgery, his eye position did not change and the right eyelid fissure demonstrated narrowing with upper eyelid lowering and lower eyelid elevation. The right upper eyelid MRD was decreased to 1.9 mm and the right lower eyelid MRD was similarly decreased to 4.3 mm. On the same day, 4 mm resection of the ipsilateral lateral rectus muscle was performed, but the same MRDs were ob-served postoperatively. Patients undergoing medial rectus muscle recession in Graves’ orbitopathy need to be informed of this potential complication.

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H. Kakizaki, Y. Takahashi, A. Ichinose and M. Iwaki, "Eyelid Fissure Narrowing after Recession of the Medial Rectus Muscle," Surgical Science, Vol. 2 No. 7, 2011, pp. 376-378. doi: 10.4236/ss.2011.27082.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] W. A. Lagrèze, J. Gerling and F. Staubach, “Changes of the Lid Fissure after Surgery on Horizontal Extraocular Muscles,” American Journal of Ophthalmology, Vol. 140, No. 6, 2005, pp. 1145-1146.
[2] M. P. Mourits, L. Koornneef, W. M. Wiersinga, M. F. Prummel, A. Berghout and R. van der Gaag, “Clinical Criteria for the Assessment of Disease Activity in Graves’ Ophthalmopathy: A Novel Approach,” British Journal of Ophthalmology, Vol. 73, No. 18, 1989, pp.639-644. doi:10.1136/bjo.73.8.639
[3] H. Kakizaki, N. Umezawa, Y. Takahashi and D. Selva, “Binocular Single Vision Field,” Ophthalmology, Vol. 116, No. 2, 2009, p. 364.
[4] H. Kakizaki, M. Zako, T. Nakano, et al., “Direct Insertion of the Medial Rectus Capsulopalpebral Fascia to the Tarsus,” Ophthalmic Plastic & Reconstructive Surgery, Vol. 24, No. 2, 2008, pp. 126-130. doi:10.1097/IOP.0b013e3181647cb2
[5] H. Kakizaki, D. Selva and I. Leibovitch, “Dynamic Study of the Medial and Lateral Recti Capsulopalpebral Fasciae Using Cine Mode Magnetic Resonance Imaging,” Ophthalmology, Vol. 117, No. 2, 2010, pp. 388-391.
[6] C. D. McCord, C. B. Boswell and T. R. Hester, “Lateral Canthal Anchoring,” Plastic and Reconstructive Surgery, Vol. 112, No. 1, 2003, pp. 222-236. doi:10.1097/01.PRS.0000066340.85485.DF
[7] A. K. Eckstein, K. T. Johnson, M. Thanos, J. Esser and M. Ludgate, “Current Insights into the Pathogenesis of Graves’ Orbitopathy,” Hormone and Metabolic Research, Vol. 41, No. 6, 2009, pp. 456-464. doi:10.1055/s-0029-1220935

  
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