Resolution of anterior segment ischemia after the removal of lateral fixation sutures

• Published in: Journal of AAPOS Vol. 12; no. 5; pp. 531 - 532
• Main Authors: Vijayalakshmi, Perumalsamy, MS, Muralidhar, Rajamani, MD, MRCO, FRCS, DNB, Shetty, Shashikanth, MS, Sane, Mona, DNB, MRCO, FICO
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-10-2008
• Subjects: Abducens Nerve Diseases - etiology; Adult; Anterior Eye Segment - blood supply; Corneal Edema - etiology; Device Removal; Humans; Ischemia - drug therapy; Ischemia - etiology; Male; Mydriatics - therapeutic use; Ophthalmology; Recovery of Function; Steroids - therapeutic use; Strabismus - etiology; Strabismus - surgery; Suture Techniques - adverse effects; Tendon Transfer; Wounds and Injuries - complications
• ISSN: 1091-8531; 1528-3933
• DOI: 10.1016/j.jaapos.2008.04.010

Anterior segment ischemia is a rare but well-recognized complication after strabismus surgery, involving multiple extraocular muscles. We report a case of traumatic left sixth nerve palsy in a 32-year-old man who developed anterior segment ischemia after left medial rectus muscle recession and partial tendon transfer of the vertical rectus muscles to the lateral rectus, augmented by lateral fixation sutures. The corneal edema and anterior chamber reaction cleared upon removal of the lateral fixation sutures and institution of steroids and cycloplegics. The possible role of lateral fixation sutures in anterior segment ischemia is discussed.