Bilateral, Unaugmented, Loop Myopexy Performed for a Severe Case of Heavy Eye Syndrome.

Q3 Medicine

British and Irish Orthoptic Journal Pub Date : 2019-02-15 DOI:10.22599/bioj.125

David Maskill, Janice Hoole, Katerina Oikonomi, Ian Simmons, Evangelos Drimtzias

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Abstract

Aim: To report the clinical features and surgical outcomes of one patient with heavy eye syndrome who underwent bilateral, unaugmented, full loop myopexy.

Methods: A 47-year-old lady with high myopia, high axial length, progressive esotropia, slippage of the lateral rectus (LR) inferiorly and superior rectus (SR) medially on magnetic resonance imaging (MRI) was diagnosed with heavy eye syndrome. Unaugmented loop myopexy without medial rectus (MR) recession was offered.

Results: On follow-up at 30 months, a small residual esotropia of 6 prism diopters (PD) at near and 10 PD at distance was achieved. Both abduction and elevation were improved in both eyes.

Conclusions: The high angle of esodeviation can be challenging to correct adequately with surgery, with many options available: resection-recession, hemitranspositions (Yamada's procedure), partial loop myopexy (modified Jensen's procedure) and full loop myopexy (Yokoyama's procedure). It remains unclear which procedure is optimal for severe disease. In this case, we present bilateral, unaugmented, full loop myopexy as our preferred choice for high esotropia.

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重度重眼综合征双侧无增强环形近视手术一例。

目的:报告1例重度眼综合征患者行双侧非增强全环性近视的临床特点和手术结果。方法:47岁女性，高度近视，高眼轴长，进行性内斜视，外直肌(LR)下、上直肌(SR)内侧滑动，磁共振成像(MRI)诊断为重眼综合征。无内侧直肌(MR)退行的非增广环形肌闭锁。结果:随访30个月，患者近处残余内斜视6个棱镜屈光度，远处残余内斜视10个棱镜屈光度。双眼外展和抬高均有改善。结论:大角度内偏难以通过手术进行充分矫正，有多种选择:切除-消退、半移位(Yamada手术)、部分环内偏(改良Jensen手术)和全环内偏(横山手术)。目前尚不清楚哪种手术对严重疾病是最佳的。在这种情况下，我们提出双侧，非增强，全环近视作为我们的首选高度内斜视。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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