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Bulgarian Review of Ophthalmology

Variations of the insertions of horizontal extraocular muscles

Alexander Oscar, Pavlin Kemilev, Violeta Chernodrinska, Galina Dimitrova, Nevyana Veleva, Ognyan Mladenov, Alina Levi

Abstract

Introduction: Determination of the scope of surgical interventions, either retropositioning or myectomies of the horizontal rectus extraocular muscles is based on calculations that do not take into account the distance of the insertion of the respective muscle. 

Aim: The aim of this article is to assess the variations of insertion of the horizontal rectus extraocular muscles. 

Materials and Methods: The research includes 63 children (126 eyes) with an average age of 4 years and 4 months (the youngest is 1y and 2m old; and the oldest is 16y old) with comitant horizontal strabismus, all of whom underwent surgery for a period of 2 years (2016 – 2018). All patients have gone through a thorough ophthalmic examination, including determination of cycloplegic refraction. Measurement was performed intraoperatively. 

Conclusion: It was determined that the median distance between the limbus and the insertion regarding the medial rectus muscle was 5.11 mm (ranging from 4.5 mm to 7 mm) and regarding the lateral rectus muscles – 6.29 mm (ranging from 5 mm to 8 mm). The main finding shows that the insertion of the horizontal rectus extraocular muscles varies significantly, which requires intraoperative refinement of the scope of surgical intervention to achieve maximum therapeutic result.


Keywords

insertion; comitant strabismus; resection; retroposition

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DOI: http://dx.doi.org/10.14748/bro.v63i1.5898

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About The Authors

Alexander Oscar
Clinic of Ophtalmology, Alexandrovska University Hospital, Sofia
Bulgaria

Pavlin Kemilev
Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia Department of Ophthalmology, Faculty of Medicine, Medical University-Sofia
Bulgaria

Department of Ophthalmology, Faculty of Medicine;

Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia

Violeta Chernodrinska
Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia Department of Ophthalmology, Faculty of Medicine, Medical University-Sofia
Bulgaria

Department of Ophthalmology, Faculty of Medicine;

Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia

Galina Dimitrova
Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia Department of Ophthalmology, Faculty of Medicine, Medical University-Sofia
Bulgaria

Department of Ophthalmology, Faculty of Medicine;

Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia

Nevyana Veleva
Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia Department of Ophthalmology, Faculty of Medicine, Medical University-Sofia
Bulgaria

Department of Ophthalmology, Faculty of Medicine;

Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia

Ognyan Mladenov
Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia Department of Ophthalmology, Faculty of Medicine, Medical University-Sofia
Bulgaria

Department of Ophthalmology, Faculty of Medicine;

Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia

Alina Levi
Clinic of Ophthalmology, Alexandrovska University Hospital, Sofia
Bulgaria

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