Repair of extraocular rectus muscle ruptures through orbitotomy

Abstract

Traumatic or iatrogenic rupture of the extraocular muscles is a rare condition. In this report, we describe 3 patients treated because of strabismus secondary to extraocular muscle rupture. The subjects were one female and two males aged 60, 65 and 11 years, respectively. All patients had severe restriction of eye movements and strabismus. The medial rectus muscle was detached during a strabismus surgery in 1 patient, and the medial or lateral rectus muscle was cut because of penetrating orbital trauma in 2 patients. The muscle injury had occurred 41 and 42 years, and 10 days ago. For treatment, the ruptured rectus muscle was found through orbitotomy and reattached in its original insertion after cleaning the surrounding scar tissue. We also performed recession surgery alone or combined with intraoperative botulinum toxin A injection to the opposite rectus muscle in 2 cases. Postoperatively, the strabismus and eye movements improved significantly in all 3 patients.