title: Muscle belly union for treatment of myopic strabismus fixus.
abstract: OBJECTIVE
  To evaluate the surgical results of the medial rectus (MR) muscle recession associated with longitudinal splitting of the lateral rectus (LR) and superior rectus (SR) muscles and surgical union of their corresponding midpoints in highly myopic patients with severe esotropia and hypotropia and restricted abduction and elevation.
  
  
  METHODS
  Six cases of severe high myopic strabismus fixus were considered with more than 90Delta esotropia and 25Delta to 30Delta hypotropia. The nasally deviated SR muscle and inferiorly shifted LR muscle were confirmed by MRI or CT scan. Supratemporal herniation of the globe from the muscle cone was also found by imaging. The LR and SR muscles were split in half from the insertion to past the equator. The lateral half of the SR muscle was united to the superior half of the LR muscle. Medial rectus muscle was recessed also.
  
  
  RESULTS
  Motility gradually improved and by 8 weeks in four cases there was 5Delta to 15Delta residual esotropia and no hypotropia and mild limitation in abduction and elevation. In two cases due to marked residual esotropia, we performed a second operation, and 2 months later residual esotropia was mild.
  
  
  CONCLUSIONS
  In highly myopic patients, if the deviant paths of the LR and SR muscles are demonstrated by MRI or CT scan, the surgical method described is effective and recommended.
authors: Department of Ophthalmology, School of Medicine, Medical Sciences/Tehran University, Tehran, Iran.
authors: Iraj
authors: I
authors: Ahadzadeghan
authors: Mohammad Reza
authors: MR
authors: Akbari
authors: Ahmad
authors: A
authors: Ameri
authors: Faramarz
authors: F
authors: Anvari
authors: Aliraza K
authors: AK
authors: Jafari
authors: Mohamad Taher
authors: MT
authors: Rajabi
mesh_terms: D000368:Aged; D004948:Esotropia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D009801:Oculomotor Muscles / Q000473:pathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods* / Q000592:standards; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult