The Polymorphism and Surgical Considerations of the Anterior Ciliary Vessels.

Purpose: To report the results of a survey on the anterior ciliary vessels (ACVs) based on intraoperative and postoperative observation to help surgeons better understand and more easily manipulate the ACVs.

Methods: This was a cross-sectional study. Patients with horizontal strabismus who had bilateral recession on the lateral rectus (LR) or medial rectus (MR) muscle and patients with vertical strabismus were included. Patients with consecutive strabismus who had previous strabismus surgery with ACV preservation were also included. The surgical images of ACVs were recorded and the anatomic and morphological characteristics were observed.

Results: There were 212 patients included in the study. Bilateral ACVs on the LR or MR of most patients were polymorphous and markedly different. Most ACVs of the LR were generally more superficial than those of other three rectus muscles. Moreover, although there was no apparent fascia tissue connected between ACVs on the other three rectus muscles, most ACVs on the LR were fully located within the orbital fascia of the muscle. So the ACVs on the LR could be separated from the surface of the muscle as a whole, whereas the ACVs on other three rectus muscles could be only preserved one by one.

Conclusions: The ACVs have obvious polymorphism. Nevertheless, most ACVs of the LR are positioned within the fascial tissue on the muscle surface; therefore all ACVs of the LR can be easily separated from the muscle as a whole.