Detailed measurements of the four extraocular rectus muscles’ contribution to the perfusion of the anterior segment of the eye
(2023) In British Journal of Ophthalmology- Abstract (Swedish)
- Background/aims Anterior segment ischaemia (ASI) is a rare but serious complication of strabismus surgery, which may be caused by damage to the anterior ciliary arteries that run along the rectus muscles. To avoid ASI, clinical praxis is to operate on a maximum of two rectus muscles at a time. The aim of this study was to perform a detailed study of the contribution of the four ocular rectus muscles to the perfusion of the anterior segment using laser speckle contrast imaging (LSCI).Methods The four rectus muscles were successively detached during enucleation in nine patients with suspected uveal melanoma. Perfusion of the anterior segment was monitored with LSCI during the detachment of each of the rectus muscles, and after the ophthalmic... (More)
- Background/aims Anterior segment ischaemia (ASI) is a rare but serious complication of strabismus surgery, which may be caused by damage to the anterior ciliary arteries that run along the rectus muscles. To avoid ASI, clinical praxis is to operate on a maximum of two rectus muscles at a time. The aim of this study was to perform a detailed study of the contribution of the four ocular rectus muscles to the perfusion of the anterior segment using laser speckle contrast imaging (LSCI).Methods The four rectus muscles were successively detached during enucleation in nine patients with suspected uveal melanoma. Perfusion of the anterior segment was monitored with LSCI during the detachment of each of the rectus muscles, and after the ophthalmic artery had been severed.Results Perfusion of the anterior segment, measured in the paralimbal tissue, decreased gradually as the four rectus muscles were detached, showing a decrease to 98% when the first (lateral rectus) muscle was detached, to 88% when the second (medial rectus), and 69% when the third (inferior rectus) muscles were detached. The decrease was more pronounced and statistically significant when the fourth (superior rectus) muscle was detached (to 28%, p=0.0102).Conclusion LSCI is a valuable perfusion monitoring tool, as it has the capability to visualise the gradual decrease in anterior segment perfusion as the rectus muscles are successively detached. Further studies are needed to determine how many rectus muscles can be safely detached during strabismus surgery without risking ASI.Data are available on reasonable request. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/7a099c27-27ac-4dc9-a9fb-66e81b06710e
- author
- Engqvist, Linn LU ; Sheikh, Rafi LU ; Öhnell, HannaMaria LU and Dahlstrand, Ulf LU
- organization
- publishing date
- 2023-12-06
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- British Journal of Ophthalmology
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85179816271
- pmid:38164569
- ISSN
- 1468-2079
- DOI
- 10.1136/bjo-2023-324468
- language
- Swedish
- LU publication?
- yes
- id
- 7a099c27-27ac-4dc9-a9fb-66e81b06710e
- date added to LUP
- 2023-12-13 16:49:28
- date last changed
- 2024-03-14 03:00:23
@article{7a099c27-27ac-4dc9-a9fb-66e81b06710e, abstract = {{Background/aims Anterior segment ischaemia (ASI) is a rare but serious complication of strabismus surgery, which may be caused by damage to the anterior ciliary arteries that run along the rectus muscles. To avoid ASI, clinical praxis is to operate on a maximum of two rectus muscles at a time. The aim of this study was to perform a detailed study of the contribution of the four ocular rectus muscles to the perfusion of the anterior segment using laser speckle contrast imaging (LSCI).Methods The four rectus muscles were successively detached during enucleation in nine patients with suspected uveal melanoma. Perfusion of the anterior segment was monitored with LSCI during the detachment of each of the rectus muscles, and after the ophthalmic artery had been severed.Results Perfusion of the anterior segment, measured in the paralimbal tissue, decreased gradually as the four rectus muscles were detached, showing a decrease to 98% when the first (lateral rectus) muscle was detached, to 88% when the second (medial rectus), and 69% when the third (inferior rectus) muscles were detached. The decrease was more pronounced and statistically significant when the fourth (superior rectus) muscle was detached (to 28%, p=0.0102).Conclusion LSCI is a valuable perfusion monitoring tool, as it has the capability to visualise the gradual decrease in anterior segment perfusion as the rectus muscles are successively detached. Further studies are needed to determine how many rectus muscles can be safely detached during strabismus surgery without risking ASI.Data are available on reasonable request.}}, author = {{Engqvist, Linn and Sheikh, Rafi and Öhnell, HannaMaria and Dahlstrand, Ulf}}, issn = {{1468-2079}}, language = {{swe}}, month = {{12}}, publisher = {{BMJ Publishing Group}}, series = {{British Journal of Ophthalmology}}, title = {{Detailed measurements of the four extraocular rectus muscles’ contribution to the perfusion of the anterior segment of the eye}}, url = {{http://dx.doi.org/10.1136/bjo-2023-324468}}, doi = {{10.1136/bjo-2023-324468}}, year = {{2023}}, }