Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Detailed measurements of the four extraocular rectus muscles’ contribution to the perfusion of the anterior segment of the eye

Engqvist, Linn LU ; Sheikh, Rafi LU orcid ; Öhnell, HannaMaria LU and Dahlstrand, Ulf LU (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:
author
; ; and
organization
publishing date
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}},
}