Case of Anterior Segment Ischemia after Two Vertical Rectus Muscles Surgery.

Ahn, Jayoung; Kim, Gyu Nam; Kim, Seong Jae; Chung, In Young; Seo, Seong Wook; Yoo, Ji Myong

doi:2018.59.12.1195

J Korean Ophthalmol Soc > Volume 59(12); 2018 > Article

Case Report

Journal of the Korean Ophthalmological Society 2018;59(12):1195-1200.
DOI: https://doi.org/10.3341/jkos.2018.59.12.1195 Published online December 15, 2018.

Case of Anterior Segment Ischemia after Two Vertical Rectus Muscles Surgery.

Jayoung Ahn, Gyu Nam Kim, Seong Jae Kim, In Young Chung, Seong Wook Seo, Ji Myong Yoo

¹Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea. yjm@gnu.ac.kr
²Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea.

두 개의 수직근수술 후 발생한 전안부허혈 1예

안자영¹⋅김규남¹⋅김성재^1,2⋅정인영^1,2⋅서성욱^1,2⋅유지명^1,2

경상대학교 의과대학 안과학교실¹, 경상대학교 건강과학연구원²

Correspondence: Ji Myong Yoo,
Email: yjm@gnu.ac.kr

Received: 19 April 2018 • Revised: 9 July 2018 • Accepted: 22 November 2018

Abstract

PURPOSE
To report a case of anterior segment ischemia after superior and inferior rectus muscle surgery in a patient with superior rectus muscle enlargement. This is the first report in the Republic of Korea of anterior segment ischemia after two rectus muscles surgery. CASE SUMMARY: An 80-year-old male was referred to our clinic with a 3 years history of diplopia. The patient had 30 prism diopters right eye hypertropia in the primary position and downgaze limitation. The orbital computed tomography scan revealed enlargement of the right superior rectus muscle. He underwent right superior rectus recession and inferior rectus resection. On postoperative day 2, slit lamp examination revealed diffuse corneal edema, Descemet's membrane folding, an aqueous flare and a dilated pupil. Treatment with 45 mg oral steroid was initiated, and 1% prednisolone acetate and 0.5% Levofloxacin eye drops were administered. At postoperative 1 month, the patient was orthophoric in the primary position, and there was no corneal edema, pupil abnormality or aqueous flare. CONCLUSIONS: Base on the present case, the possibility of anterior segment ischemia should be considered after even two muscles surgery, and older patients with vertical muscle surgery should be considered more carefully.

Key Words: Anteior eye segment;Ischemia;Oculomotor muscles