J Korean Ophthalmol Soc.  2017 Feb;58(2):235-239. 10.3341/jkos.2017.58.2.235.

A Case of Immediate Surgical Repair in Traumatic Isolated Inferior Rectus Muscle Rupture

• Lee BR
• Lim KH

• KMID: 2369476
• DOI: http://doi.org/10.3341/jkos.2017.58.2.235

Abstract

PURPOSE
We report a case of infraduction limitation improvement and orthotropia at primary position in a patient with traumatic isolated inferior rectus muscle rupture after immediate repair surgery of the ruptured muscle.
CASE SUMMARY
A 47-year-old man came to our emergency department complaining of right eyelid contusion and conjunctival laceration after trauma due to the metal part of a high pressure hose. Right hypertropia of 20 prism diopters was observed at primary gaze and right hypertropia of 30 prism diopters was observed at down gaze. The right eye showed a -4 infraduction limitation. We sutured the distal part of the ruptured inferior rectus muscle with surrounding tissue, including the Tenon's capsule and the part of the muscle stump, to its original insertion. Orthotropia at primary position and 8-prism-diopters of right hypertropia on down gaze was observed one day after surgery. At 40 days after surgery, the patient had orthotropia at primary position and 4-prism-diopter right hypertropia on down gaze. Infraduction limitation of the right eye improved to -1.
CONCLUSIONS
Immediate repair of complete traumatic isolated inferior rectus muscle rupture can correct the limitation of extraocular movement and achieve orthotropia at primary position.

Keyword

Inferior rectus muscle rupture; Strabismus surgery; Trauma

MeSH Terms

Contusions
Emergency Service, Hospital
Eyelids
Humans
Lacerations
Middle Aged
Rupture*
Strabismus
Tenon Capsule

Figure

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  Figure 1. Preoperative clinical findings. Right hypertropia is noted at primary position and down gaze. Right eye reveals marked limitation of depression.

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  Figure 2. Postoperative clinical findings at the 1st day after surgery. Improvement of right hypertropia is noted at primary position.

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  Figure 3. Postoperative clinical findings at 40 days after surgery. Improvement of infraduction of the right eye and right hypertropia are shown.

Reference

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