Dynamic study of the medial and lateral recti capsulopalpebral fasciae using cine mode magnetic resonance imaging.
OBJECTIVE
To assess the dynamic features of the medial rectus capsulopalpebral fascia (mrCPF) and the lateral rectus CPF (lrCPF) during horizontal eye movements using cine mode magnetic resonance imaging (MRI).


METHODS
Observational case series.


METHODS
Ten patients (9 males and 1 female; age range, 8-75 years; mean age, 41.1 years) diagnosed with a unilateral orbital blowout fracture (medial wall, floor, or both) and having a normal contralateral orbit.


METHODS
Cine mode MRI was used to examine the role of the mrCPF and the lrCPF in relation to the eyelid and horizontal recti muscles during horizontal eye movements.


METHODS
To assess the dynamic features of the mrCPF and the lrCPF.


RESULTS
In medial gaze, the medial part of the eyelid moves posteromedially, in synchronicity with medial rectus muscle contraction, mediated by the mrCPF. The lateral part of the eyelid moves anteromedially, in synchronicity with lateral rectus muscle relaxation, mediated by the lrCPF. In lateral gaze, the lateral part of the eyelid moves posterolaterally, in synchronicity with the lateral rectus muscle contraction, mediated by the lrCPF. The medial part of the eyelid moves anterolaterally, in synchronicity with medial rectus muscle relaxation, mediated by the mrCPF. These findings were demonstrated in all 10 patients.


CONCLUSIONS
Cine mode MRI was used to demonstrate the dynamic roles of the mrCPF and the lrCPF in mediating eyelid position with the corresponding horizontal recti muscles. This study may allow a better understanding of the importance of these anatomic structures and may reduce functional and cosmetic complications during common oculoplastic and strabismus surgeries.
Kakizaki
Hirohiko
H
Department of Oculoplastic and Orbital Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan. cosme@d1.dion.ne.jp
Selva
Dinesh
D
Leibovitch
Igal
I
D000328:Adult; D000368:Aged; D002648:Child; D005133:Eye Movements / Q000502:physiology*; D005143:Eyelids / Q000503:physiopathology*; D005205:Fascia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D009917:Orbital Fractures / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult