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      Is the Insertional Anatomy of Rectus Extraocular Muscles Binocularly Symmetrical?


      Ophthalmic Research

      S. Karger AG

      Symmetry, Cadaver, Extraocular muscle, Insertion

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          Purpose: This study was performed to examine the location, width, and insertional shape of rectus extraocular muscles (EOMs), and to elucidate the symmetry of the insertional anatomy of rectus EOMs in the left and right eyes. Methods: EOMs were dissected from their origin to the insertion point in 100 intact orbits of 50 cadavers. The width, location, and shape of 4 rectus EOMs insertions were measured. The insertional shapes were classified into 6 categories: straight, oblique, convex, oblique-convex, concave, and nonspecific types. Results: The most common types of insertional shapes were superior rectus muscle, oblique type (34%); inferior rectus muscle, oblique type (7%); lateral rectus muscle, concave type (41%); and medial rectus muscle, straight type (37%). The distance from the limbus to insertion and the width of rectus EOMs were almost symmetrical between the left and right eyes of the paired specimens. However, the insertional shapes were different in 46% of the superior rectus, 56% of the inferior rectus, 58% of the lateral rectus, and 46% of the medial rectus muscles. In a given individual, 49 individuals demonstrated asymmetric insertional shapes in at least 1 rectus EOM in both eyes. Conclusions: Ocular surgeons should consider the possibility of differences in the insertional shape of rectus EOMs between the left and right eyes, especially when performing rectus EOM recession.

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          Most cited references 6

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          Slanted lateral rectus recession for exotropia with convergence weakness.

          To evaluate the efficacy of slanted recession of the lateral rectus (LR) muscle for exotropia (XT) with convergence weakness.
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            A Randomized Comparison of Surgical Procedures for Infantile Esotropia

            In a prospective, randomized, masked study we compared the treatment of infantile esotropia using bilateral medial rectus muscle recessions of a graded amount from the insertion to standard 10.5-mm recession from the corneoscleral limbus. Of the patients undergoing recession of the medial recti muscles 10.5 mm from the corneoscleral limbus, 33 of 39 (84%) achieved a final ocular alignment within 10 prism diopters of straight with one operation, compared to 26 of 41 (63%) of the patients undergoing a graded recession from the insertion. The difference was significant (.01 less than P less than .05 by the chi-square test).
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                Author and article information

                Ophthalmic Res
                Ophthalmic Research
                S. Karger AG
                April 2010
                31 December 2009
                : 43
                : 4
                : 179-184
                Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
                272021 Ophthalmic Res 2010;43:179–184
                © 2009 S. Karger AG, Basel

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                Page count
                Figures: 2, Tables: 3, References: 12, Pages: 6
                Original Paper

                Vision sciences, Ophthalmology & Optometry, Pathology

                Extraocular muscle, Cadaver, Insertion, Symmetry


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