Leilei Zou1,2,3, Shuai Liu1,2,3, Rui Liu1,2,3, Jing Yao1,2,3, Yan Liu1,2,3, Jing Lin1,2,3, Hong Liu1,2,3. 1. Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China. 2. Key Laboratory of Myopia, Ministry of Health, Shanghai, China. 3. Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital, Fudan University, Shanghai, China.
Abstract
IMPORTANCE: This study introduces a modified loop myopexy technique for severe high myopic strabismus fixus. BACKGROUND: This study aims to evaluate the surgical results of loop myopexy with or without medial rectus recession for the treatment of patients with myopic strabismus fixus. DESIGN: This is a retrospective study in a Chinese teaching hospital. PARTICIPANTS: Data was collected from 25 myopic strabismus fixus patients (33 eyes) with restriction in both abduction and sursumduction. METHODS: First, the loop myopexy technique was performed. Following the loop myopexy technique, a medial rectus recession was performed if esotropia remained. If esotropia and/or hypotropia still persisted, second-stage surgery of the contralateral eye was performed. MAIN OUTCOME MEASURES: The main outcome measures were ocular deviations, eye movements and the angles of dislocation of the globe. RESULTS: At the last follow-up, mean deviation of esotropia was significantly improved (10 vs. 92 PD; p = 0.000), while mean deviation of hypotropia was improved (6 vs. 32 PD; p = 0.008). Mean abduction limitation was improved (-2.7 vs. -5.0; p = 0.000); mean elevation limitation improved (-3.2 vs. -5.0; p = 0.000). The angle of dislocation of the globe was significantly decreased (103.0 vs. 235.3 D; p = 0.002). CONCLUSIONS AND RELEVANCE: Modified Yokoyama's surgery effectively corrected the restrictive esotropia and hypotropia, restored the dislocated globe back into the muscle cone and improved the eye movement in severe myopic strabismus fixus.
IMPORTANCE: This study introduces a modified loop myopexy technique for severe high myopic strabismus fixus. BACKGROUND: This study aims to evaluate the surgical results of loop myopexy with or without medial rectus recession for the treatment of patients with myopic strabismus fixus. DESIGN: This is a retrospective study in a Chinese teaching hospital. PARTICIPANTS: Data was collected from 25 myopic strabismus fixus patients (33 eyes) with restriction in both abduction and sursumduction. METHODS: First, the loop myopexy technique was performed. Following the loop myopexy technique, a medial rectus recession was performed if esotropia remained. If esotropia and/or hypotropia still persisted, second-stage surgery of the contralateral eye was performed. MAIN OUTCOME MEASURES: The main outcome measures were ocular deviations, eye movements and the angles of dislocation of the globe. RESULTS: At the last follow-up, mean deviation of esotropia was significantly improved (10 vs. 92 PD; p = 0.000), while mean deviation of hypotropia was improved (6 vs. 32 PD; p = 0.008). Mean abduction limitation was improved (-2.7 vs. -5.0; p = 0.000); mean elevation limitation improved (-3.2 vs. -5.0; p = 0.000). The angle of dislocation of the globe was significantly decreased (103.0 vs. 235.3 D; p = 0.002). CONCLUSIONS AND RELEVANCE: Modified Yokoyama's surgery effectively corrected the restrictive esotropia and hypotropia, restored the dislocated globe back into the muscle cone and improved the eye movement in severe myopic strabismus fixus.