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Case Reports
. 2019 Feb 15;15(1):25-27.
doi: 10.22599/bioj.125.

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

David Maskill  1 , Janice Hoole  1 , Katerina Oikonomi  2 , Ian Simmons  1 , Evangelos Drimtzias  1
Affiliations
Case Reports

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

David Maskill et al. Br Ir Orthopt J. .

Abstract

Aim: To report the clinical features and surgical outcomes of one patient with heavy eye syndrome who underwent bilateral, unaugmented, full loop myopexy.

Methods: A 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.

Results: On 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.

Conclusions: The 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.

Keywords: Heavy eye syndrome; Progressive esotropia.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Primary position, right and left gaze of our patient at presentation.
Figure 2
Figure 2
Magnetic resonance imaging of the orbit showing superotemporal herniation of the eyeball with inferior displaced lateral rectus (thick arrows) and nasally displaced superior rectus muscles (thin arrows).
Figure 3
Figure 3
Primary position, right and left gaze at last review.
See this image and copyright information in PMC

References

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