Rectus muscle pseudo-adherence syndrome

Purpose: To describe a clinical entity called “rectus muscle pseudo-adherence syndrome” following buckling surgery. Methods: A retrospective data review was undertaken to analyze the clinical profile of strabismus patients who had developed it following buckling surgery. Between 2017 and 2021, a t...

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Main Authors: Amar Pujari, Baiju Virani, Nidhi Chauhan, Karthikeyan Mahalingam, Rajeswari Thangavel, Rohit Saxena
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=5;spage=2084;epage=2088;aulast=Pujari
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author Amar Pujari
Baiju Virani
Nidhi Chauhan
Karthikeyan Mahalingam
Rajeswari Thangavel
Rohit Saxena
author_facet Amar Pujari
Baiju Virani
Nidhi Chauhan
Karthikeyan Mahalingam
Rajeswari Thangavel
Rohit Saxena
author_sort Amar Pujari
collection DOAJ
description Purpose: To describe a clinical entity called “rectus muscle pseudo-adherence syndrome” following buckling surgery. Methods: A retrospective data review was undertaken to analyze the clinical profile of strabismus patients who had developed it following buckling surgery. Between 2017 and 2021, a total of 14 patients were identified. The demography, surgical details, and intraoperative challenges were reviewed. Results: The average age of the 14 patients was 21.71 ± 5.23 years. The mean pre-op deviation was 42.35 ± 14.35 prism diopters (PD) of exotropia, and the mean post-op deviation was 8.25 ± 4.88 PD of residual exotropia at 26.16 ± 19.53 months follow-up. Intraoperatively, in the absence of a buckle, the thinned-out rectus adhered to the underlying sclera with much denser adhesions along its margins. When there was a buckle, the rectus muscle adhered to the outer surface of the buckle again, but less densely, with marginal union into the surrounding tenons. In both scenarios, due to the absence of protective muscle coverings, the rectus muscles were naturally adsorbed onto the immediately available surface in the presence of active healing by the tenons. Conclusion: While correcting ocular deviations following buckling surgery, a false sense of an absent, slipped, or thinned-out rectus muscle is very much possible. This is due to active healing of the muscle with the surrounding sclera or the buckle in a single layer of tenons. This is the rectus muscle pseudo-adherence syndrome, where the culprit is the healing process and not the muscle.
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spelling doaj.art-fe53f60186334c9792eef22cf53419b12023-07-21T15:14:10ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892023-01-017152084208810.4103/ijo.IJO_2075_22Rectus muscle pseudo-adherence syndromeAmar PujariBaiju ViraniNidhi ChauhanKarthikeyan MahalingamRajeswari ThangavelRohit SaxenaPurpose: To describe a clinical entity called “rectus muscle pseudo-adherence syndrome” following buckling surgery. Methods: A retrospective data review was undertaken to analyze the clinical profile of strabismus patients who had developed it following buckling surgery. Between 2017 and 2021, a total of 14 patients were identified. The demography, surgical details, and intraoperative challenges were reviewed. Results: The average age of the 14 patients was 21.71 ± 5.23 years. The mean pre-op deviation was 42.35 ± 14.35 prism diopters (PD) of exotropia, and the mean post-op deviation was 8.25 ± 4.88 PD of residual exotropia at 26.16 ± 19.53 months follow-up. Intraoperatively, in the absence of a buckle, the thinned-out rectus adhered to the underlying sclera with much denser adhesions along its margins. When there was a buckle, the rectus muscle adhered to the outer surface of the buckle again, but less densely, with marginal union into the surrounding tenons. In both scenarios, due to the absence of protective muscle coverings, the rectus muscles were naturally adsorbed onto the immediately available surface in the presence of active healing by the tenons. Conclusion: While correcting ocular deviations following buckling surgery, a false sense of an absent, slipped, or thinned-out rectus muscle is very much possible. This is due to active healing of the muscle with the surrounding sclera or the buckle in a single layer of tenons. This is the rectus muscle pseudo-adherence syndrome, where the culprit is the healing process and not the muscle.http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=5;spage=2084;epage=2088;aulast=Pujaribuckling surgerypseudo-adherencerectus muscle
spellingShingle Amar Pujari
Baiju Virani
Nidhi Chauhan
Karthikeyan Mahalingam
Rajeswari Thangavel
Rohit Saxena
Rectus muscle pseudo-adherence syndrome
Indian Journal of Ophthalmology
buckling surgery
pseudo-adherence
rectus muscle
title Rectus muscle pseudo-adherence syndrome
title_full Rectus muscle pseudo-adherence syndrome
title_fullStr Rectus muscle pseudo-adherence syndrome
title_full_unstemmed Rectus muscle pseudo-adherence syndrome
title_short Rectus muscle pseudo-adherence syndrome
title_sort rectus muscle pseudo adherence syndrome
topic buckling surgery
pseudo-adherence
rectus muscle
url http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=5;spage=2084;epage=2088;aulast=Pujari
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AT baijuvirani rectusmusclepseudoadherencesyndrome
AT nidhichauhan rectusmusclepseudoadherencesyndrome
AT karthikeyanmahalingam rectusmusclepseudoadherencesyndrome
AT rajeswarithangavel rectusmusclepseudoadherencesyndrome
AT rohitsaxena rectusmusclepseudoadherencesyndrome