J Korean Ophthalmol Soc.  2021 Feb;62(2):289-293. 10.3341/jkos.2021.62.2.289.

Surgery in a Patient with Sensory Exotropia with an Abnormally Attached Lateral Rectus Muscle

• Lee SH
• Noh GM
• Lee SU
• Lee SJ
• Kim CZ

• KMID: 2512952
• DOI: http://doi.org/10.3341/jkos.2021.62.2.289

Abstract

Purpose
We report surgical repair of an abnormally attached lateral rectus muscle in a sensory exotropia patient.
Case summary
A 21-year-old man visited our hospital with lateral deviation in the right eye. The patient had a history of trauma (11 years previously) to the right eye, which showed 30 prism diopters of exotropia. In accordance with a diagnosis of sensory exotropia, 7.5-mm lateral rectus muscle recession and 6-mm medial rectus muscle resection were planned in the right eye. During surgery, the lateral rectus muscle was inserted into the sclera at a distance of 12 mm from the corneal limbus. To compensate for this, the lateral rectus muscle was recessed with an adjustable suture. After surgery, the patient showed 8-10 prism diopters of exotropia. A 2-mm recession was achieved by suturing. After surgery, the patient did not show exotropia, while after 3 months of follow-up the patient showed about 4 prism diopters of esotropia.
Conclusions
Despite abnormal attachment of an extraocular muscle, it is possible to obtain a good cosmetic result if the surgery is performed according to the preoperative plan. Suturing can be helpful if the surgical field is difficult to secure during the surgery.

Keyword

Abnormal attachment, Extraocular muscle, Sensory exotropia, Strabismus