Back to Search
Start Over
Detailed measurements of the four extraocular rectus muscles' contribution to the perfusion of the anterior segment of the eye.
- Source :
-
The British journal of ophthalmology [Br J Ophthalmol] 2024 Aug 22; Vol. 108 (9), pp. 1328-1332. Date of Electronic Publication: 2024 Aug 22. - Publication Year :
- 2024
-
Abstract
- Background/aims: Anterior segment ischaemia (ASI) is a rare but serious complication of strabismus surgery, which may be caused by damage to the anterior ciliary arteries that run along the rectus muscles. To avoid ASI, clinical praxis is to operate on a maximum of two rectus muscles at a time. The aim of this study was to perform a detailed study of the contribution of the four ocular rectus muscles to the perfusion of the anterior segment using laser speckle contrast imaging (LSCI).<br />Methods: The four rectus muscles were successively detached during enucleation in nine patients with suspected uveal melanoma. Perfusion of the anterior segment was monitored with LSCI during the detachment of each of the rectus muscles, and after the ophthalmic artery had been severed.<br />Results: Perfusion of the anterior segment, measured in the paralimbal tissue, decreased gradually as the four rectus muscles were detached, showing a decrease to 98% when the first (lateral rectus) muscle was detached, to 88% when the second (medial rectus), and 69% when the third (inferior rectus) muscles were detached. The decrease was more pronounced and statistically significant when the fourth (superior rectus) muscle was detached (to 28%, p=0.0102).<br />Conclusion: LSCI is a valuable perfusion monitoring tool, as it has the capability to visualise the gradual decrease in anterior segment perfusion as the rectus muscles are successively detached. Further studies are needed to determine how many rectus muscles can be safely detached during strabismus surgery without risking ASI.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Regional Blood Flow physiology
Eye Enucleation
Uveal Neoplasms
Ischemia physiopathology
Ischemia diagnosis
Ischemia etiology
Adult
Strabismus physiopathology
Strabismus surgery
Ophthalmic Artery diagnostic imaging
Melanoma
Oculomotor Muscles surgery
Oculomotor Muscles physiopathology
Oculomotor Muscles diagnostic imaging
Anterior Eye Segment diagnostic imaging
Anterior Eye Segment blood supply
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2079
- Volume :
- 108
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The British journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 38164569
- Full Text :
- https://doi.org/10.1136/bjo-2023-324468