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Muscles of the Eye

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The muscles of the eye are sophisticated structures that control eye movement and focus, allowing for the precise and rapid adjustments necessary for vision. The human eye is controlled by ten muscles — six extraocular muscles, three intraocular muscles, and one primary eyelid retractor muscle.
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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

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Surgery for complete vertical rectus paralysis combined with horizontal strabismus.

Leilei Zou¹, Rui Liu¹, Yan Liu¹

¹Department of Ophthalmology, Eye and ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai 200031, China ; Key Laboratory of Myopia, Ministry of Health PR China, 83 Fenyang Road, Shanghai 200031, China ; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, 83 Fenyang Road, Shanghai 200031, China.

Journal of Ophthalmology

|June 3, 2014

Summary

This study shows that combining augmented partial rectus muscle transposition (APRMT) with horizontal strabismus surgery effectively corrects both vertical rectus paralysis and large horizontal deviations. The combined approach is safe and yields significant improvements in alignment.

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Area of Science:

Ophthalmology
Strabismus Surgery
Oculomotorics

Background:

Vertical rectus paralysis often coexists with moderate-to-large angle horizontal strabismus.
Simultaneous surgical correction presents unique challenges and requires tailored approaches.

Purpose of the Study:

To evaluate the outcomes of combined augmented partial rectus muscle transposition (APRMT) and horizontal rectus recession-resection for concurrent vertical and horizontal strabismus.
To assess the safety and efficacy of this combined surgical technique.

Main Methods:

Patients with vertical rectus paralysis and horizontal strabismus underwent staged or simultaneous surgery based on preoperative forced duction testing.
The surgical approach included APRMT combined with partial horizontal rectus recession-resection, with potential adjustments in the contralateral eye.

Main Results:

The study included ten patients with a mean age of 22.3 years and a mean follow-up of 7.1 months.
APRMT corrected a mean vertical deviation of 21.4 PD.
Horizontal deviation significantly decreased from a mean of 48.5 PD preoperatively to 3.0 PD at 6 months postoperatively.

Conclusions:

Combined APRMT and partial horizontal rectus recession-resection is a safe and effective treatment for patients with complete vertical rectus paralysis and moderate-to-large angle horizontal strabismus.
This surgical strategy successfully corrects both vertical and horizontal deviations, improving ocular alignment.