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Rafi Sheikh, MD, PhD. Photo.

Rafi Sheikh

Research project participant

Rafi Sheikh, MD, PhD. Photo.

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

Author

  • Linn Engqvist
  • Rafi Sheikh
  • HannaMaria Öhnell
  • Ulf Dahlstrand

Summary, in 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 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.

Department/s

  • Ophthalmology, Lund
  • LU Profile Area: Light and Materials
  • Ophthalmology Imaging Research Group
  • LTH Profile Area: Photon Science and Technology
  • Retinopathy of Prematurity
  • Ophthalmology (Malmö)

Publishing year

2024

Language

Swedish

Pages

1328-1332

Publication/Series

British Journal of Ophthalmology

Volume

108

Issue

9

Document type

Journal article

Publisher

BMJ Publishing Group

Topic

  • Ophthalmology

Status

Published

Research group

  • Ophthalmology Imaging Research Group
  • Retinopathy of Prematurity
  • Ophthalmology (Malmö)

ISBN/ISSN/Other

  • ISSN: 1468-2079