Bhate Manjushree
Strabismus Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, L.V. Prasad Eye Institute, Hyderabad India.
J AAPOS. 2024 Feb;28(1):103798. doi: 10.1016/j.jaapos.2023.09.009. Epub 2023 Nov 19.
This report describes a rare occurrence of double-bellied inferior rectus muscle with aplasia of the medial rectus muscle in both eyes of a young woman seeking cosmetic correction for her strabismus. The patient presented with a large-angle exotropia and a -4 limitation of adduction in each eye. On attempted adduction, there was minimal downshoot and upper eyelid retraction. Magnetic resonance imaging of the orbit revealed hypoplastic medial rectus muscles; however, intraoperatively the muscle was not found at the insertion or when traced back as far as possible. The inferior rectus muscles were noted to have double bellies converging close to each other at the insertion. The patient underwent a bilateral lateral rectus recession with nasal transposition of the inferior rectus muscles and was cosmetically well aligned, with a residual exotropia of 4 at 3 months' follow-up. This unusual anatomical variation may be the result of deviation of muscle paths.
本报告描述了一名年轻女性双眼罕见的下直肌双腹合并内直肌发育不全的情况，该女性因斜视寻求美容矫正。患者表现为大角度外斜视，每只眼内收受限-4。试图内收时，下转和上睑退缩轻微。眼眶磁共振成像显示内侧直肌发育不全；然而，术中在插入处或尽可能向后追踪时均未发现该肌肉。注意到下直肌有双腹，在插入处彼此靠近汇聚。患者接受了双侧外直肌后徙术及下直肌鼻侧移位术，术后外观对齐良好，随访3个月时残留4外斜视。这种不寻常的解剖变异可能是肌肉路径偏差的结果。
