Loop Myopexy Surgery for Strabismus Associated with High Myopia

Table 1

Summary on literatures about surgical treatment of high myopic strabismus.

Procedures	Authors	Number of cases	Preoperative strabismus	Surgical management	Patients’ outcome	Follow-up (months)
Yokoyama’s procedure	Wong et al., 2005 [7]	2	Case 1: 70^Δ esotropia and 25^Δ hypotropia with limited ocular movement; Case 2: fixed eye position in adduction and depression	Union of the SR and LR 12 mm behind the limbus; Case 1: with a 5-0 Mersilk suture; Case 2: with a 240 band and silicon sleeve	Case 1: 10^Δ esotropia with mild limitation in abduction; Case 2: 14^Δ exotropia, limitation in abduction (−1) in the right eye, adduction (−2) in the left eye, and elevation (−1) in both eyes	Case 1: 15; Case 2: 14
	Rowe and Noonan, 2006 [8]	1	70^Δ esotropia and 25^Δ hypotropia	Union of the temporal half of SR and the upper half of LR, placed posterior to the equator by 5-0 polybutilate-coated polyester suture; recession of the MR for 6 mm	20^Δ hypotropia, mild limitation of elevation and abduction	12
	Basmak et al., 2008 [9]	1	Fixed eye position and restricted ocular motility	Union of the SR and LR 15 mm behind their insertions with a nonabsorbable polyester suture; recession of the MR 12 mm from the limbus	Restoration of the dislocated eyeball and improvement of ocular motility, but mild restriction in all gaze directions	24
	Yamaguchi et al., 2010 [10]	21	Angles of deviation 58.8 ± 36.0°	Union of the SR and LR 15 mm behind the insertions with a polyester suture; recession of the MR for 5 to 8 mm	Angles of deviation of 0.7 ± 9.0° degrees, great improvement in abduction and sursumduction	48.8
	Durnian et al., 2010 [11]	5	13^Δ esotropia and 21.8^Δ hypotropia	Union of half of the SR and LR 14 mm behind their insertions with 5-0 nonabsorbable suture	Hypotropia deviation of 0^Δ and vertical deviation of 4.4^Δ	6
	Shih et al., 2012 [12]	1	Severe limitation of ductions in all directions	Union of the SR and LR 5 to 7 mm posterior to their insertions with a polytetrafluoroethylene (Gore-Tex) Sling and 5-0 polyester suture; recession of the MR for 8 mm and LR for 6 mm	12^Δ esotropia with limitation in supraduction (−3)	7
	Akbari et al., 2013 [13]	1	Fixed eye position in adduction and infraduction	Union of the SR and LR with a polyester suture; recession of the MR and resection of LR	Binocularly aligned	12
	Akar et al., 2014 [14]	20	58.6 ± 2.5^Δ esotropia and 12.5 ± 1.3^Δ hypotropia	Union of the lateral one-quarter of the SR and the superior one-quarter of the LR 14 to 15 mm posterior to the insertions with a double-armed 5-0 polybutilate-coated polyester suture; recession of the MR for 8 to 10 mm	6.8 ± 1.4^Δ esotropia, 3.3 ± 1.1^Δ hypotropia, and significant improvement in abduction and supraduction	48
	Acar and Altintas, 2015 [15]	2	Case 1: 65^Δ esotropia; Case 2: 85^Δ esotropia	Union of the SR and LR with a 5-0 nonabsorbable polyester suture; recession of the MR for 5.75 mm	Case 1: 16^Δ at near and distance; Case 2: 12^Δ at near and 14^Δ at distance, mild limitation in abduction (−1)	Case 1: 36; Case 2: 25
	Shenoy et al., 2015 [16]	15	79.3 ± 32.3^Δ esotropia and 8.9 ± 10.1^Δ hypotropia	Union of the SR and LR 14 to 16 mm from the limbus through a 3 to 4 length scleral tunnel with 240 silicone band and 5-0 nonabsorbable polyester suture; recession of the MR for 5 to 7.5 mm	16.9 ± 17.4^Δ esotropia, 0.6 ± 1.3^Δ hypotropia, and success rate (deviation 20^Δ) 73%	7.9 ± 8.5
Yamada’s procedure	Yamada et al., 2002 [17]	1	Fixed eye position in extreme adduction and restricted ocular motility	Hemitransposition of the SR and LR with scleral fixation 7 mm from the limbus; recession of the MR for 8 mm	10^Δ esotropia with mild limitation in supraduction and abduction	12
	Sturm et al., 2008 [18]	1	Fixed eye position in extreme adduction and depression	Hemitransposition of the SR and LR with a new insertion at 7 mm posterior from the limbus and myopexy of translocated muscles with scleral fixation at 15 mm from the new insertion; recession of MR for 10 mm	20° esotropia with slightly limited ocular motility in abduction, elevation, and adduction	12
	Godeiro et al., 2009 [19]	2	Case 1: 50^Δ esotropia and 12^Δ hypotropia; Case 2: 60^Δ esotropia and 10^Δ hypotropia	4 mm resection and hemitransposition of the SR and LR with scleral fixation at 7 mm from the limbus by 6-0 mersilene; Case 1: 5 IU botulinum toxin injection into the MR; then recession of the MR for 6 mm; Case 2: recession of the MR for 6 mm	Case 1: satisfactory alignment with mild limitation in abduction and elevation at 8 months; Case 2: excellent ocular alignment with a marked improvement in abduction and elevation	Case 1: 8; Case 2: 6
Partial Jensen’s procedure	Larsen and Gole, 2004 [20]	1	50^Δ esotropia and 30^Δ hypotropia	Union of the lateral half of the SR and the superior half of the LR 14 mm from the limbus with 5-0 Dacron suture	Significant improvement in abduction and supraduction	9
	Ahadzadeghan et al., 2009 [21]	6	≫90^Δ esotropia and 25 to 30^Δ hypotropia	Union of the lateral half of the SR and the superior half of the LR 16 mm from the limbus with 5-0 Dacron suture; recession of the MR for 6 to 10 mm	5 to 20^Δ esotropia and mild limitation in abduction and elevation	2
	Rajavi et al., 2009 [22]	2	Case 1: 40^Δ esotropia and 5^Δ hypotropia; Case 2: 50^Δ esotropia and 2^Δ hypotropia	Union of the lateral half of the SR and the superior half of the LR posterior to the equator with a 5-0 nonabsorbable polybutilate-coated polyester suture	Case 1: 10 to 12^Δ esotropia and 3^Δ hypotropia, slightly restricted abduction (−1); Case 2: 25^Δ for far and 20^Δ for near esotropia and 2^Δ hypotropia, mild restriction (−1) in abduction	Case 1: 3; Case 2: 2
	Kang et al., 2011 [23]	5	82.86 ± 37.62^Δ esotropia and 20 ± 7.91^Δ hypotropia	Union of the lateral half of the SR and the superior half of the LR 12 to 14 mm from the insertions with a 5-0 nonabsorbable polyester suture; recession of the MR for 6 to 10 mm	Significant improvement in dislocation of the globe, ocular motility, and horizontal and vertical deviations	5
	Ho et al., 2012 [24]	2	>90^Δ esotropia and marked limitation on abduction (−3)	Union of the lateral half of the SR and the superior half of the LR 14 mm from the limbus with a 5-0 Dacron nonabsorbable suture; recession of the MR for 8 to 8.5 mm	Case 1: great improvement in ocular motility and alignment with 10^Δ esotropia; Case 2: improved motility with 4^Δ esotropia	Case 1: not mentioned; Case 2: 10