Bilateral, Unaugmented, Loop Myopexy Performed for a Severe Case of Heavy Eye Syndrome

• Published in: The British and Irish orthoptic journal Vol. 15; no. 1; pp. 25 - 27
• Main Authors: Maskill, David, Hoole, Janice, Oikonomi, Katerina, Simmons, Ian, Drimtzias, Evangelos
• Format: Report
• Language: English
• Published: 15-02-2019
• ISSN: 1743-9868
• DOI: 10.22599/bioj.125

AIMTo report the clinical features and surgical outcomes of one patient with heavy eye syndrome who underwent bilateral, unaugmented, full loop myopexy. METHODSA 47-year-old lady with high myopia, high axial length, progressive esotropia, slippage of the lateral rectus (LR) inferiorly and superior rectus (SR) medially on magnetic resonance imaging (MRI) was diagnosed with heavy eye syndrome. Unaugmented loop myopexy without medial rectus (MR) recession was offered. RESULTSOn follow-up at 30 months, a small residual esotropia of 6 prism diopters (PD) at near and 10 PD at distance was achieved. Both abduction and elevation were improved in both eyes. CONCLUSIONSThe high angle of esodeviation can be challenging to correct adequately with surgery, with many options available: resection-recession, hemitranspositions (Yamada's procedure), partial loop myopexy (modified Jensen's procedure) and full loop myopexy (Yokoyama's procedure). It remains unclear which procedure is optimal for severe disease. In this case, we present bilateral, unaugmented, full loop myopexy as our preferred choice for high esotropia.