Yokoyama procedure for a woman with heavy eye syndrome who underwent multiple recession-resection operations: A case report.

BACKGROUND: Heavy eye syndrome (HES) is an acquired strabismus typically seen in eyes with high myopia. We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial rectus muscle and lateral rectus muscle resection procedures. CASE SUMMARY: A 71-year-old woman presented with both eyes fixed in adduction and infraduction for 33 years. She had undergone three complicated strabismus surgeries to amputate the left medial rectus (MR) muscle with lateral rectus muscle recession, but no improvement in the esotropia appeared after each operation. She was diagnosed with HES and underwent a bilateral Yokoyama procedure and recession of the right MR muscle under general anesthesia. After surgery, her eyes were binocularly aligned for 6 mo. This case suggests that pertinacious esotropia combined with high myopia must be considered in HES. Orbital imaging and ultrasonography can demonstrate anatomical abnormality and muscle paths to confirm a definite diagnosis. CONCLUSION: The Yokoyama procedure was effective in correcting HES.

Recession-resection surgery augmented with botulinum toxin a chemodenervation for paralytic horizontal strabismus.

In this case series study, we assessed the effects of recession-resection surgery augmented with botulinum toxin A chemodenervation for patients with chronic paralytic horizontal strabismus. In addition, we compared these effects with those of full tendon transposition (FTT) augmented with posterior intermuscular suture (PIMS). Ten patients who underwent strabismus surgery due to paralytic horizontal strabismus were retrospectively reviewed. They received a recession-resection surgery augmented with botulinum toxin A chemodenervation (type I surgery) or a FTT augmented with PIMS (type II surgery). The preoperative angle of deviation (AOD) and postoperative improvement in AOD were compared according to the type of procedure. The preoperative AOD was 60.00 ± 28.50 prism diopters (PD) for type I surgery and 68.00 ± 27.06 PD for type II (p = 0.421). Improvement in AOD was 53.20 ± 25.01 PD for type I surgery and 44.20 ± 18.74 PD for type II (p = 0.548). Recession-resection surgery augmented with botulinum toxin A chemodenervation is a concise and effective procedure for treating paralytic horizontal strabismus.

Recession-Resection Surgery Augmented with Botulinum Toxin A Chemodenervation for Paralytic Horizontal Strabismus

In this case series study, we assessed the effects of recession-resection surgery augmented with botulinum toxin A chemodenervation for patients with chronic paralytic horizontal strabismus. In addition, we compared these effects with those of full tendon transposition (FTT) augmented with posterior intermuscular suture (PIMS). Ten patients who underwent strabismus surgery due to paralytic horizontal strabismus were retrospectively reviewed. They received a recession-resection surgery augmented with botulinum toxin A chemodenervation (type I surgery) or a FTT augmented with PIMS (type II surgery). The preoperative angle of deviation (AOD) and postoperative improvement in AOD were compared according to the type of procedure. The preoperative AOD was 60.00 +/- 28.50 prism diopters (PD) for type I surgery and 68.00 +/- 27.06 PD for type II (p = 0.421). Improvement in AOD was 53.20 +/- 25.01 PD for type I surgery and 44.20 +/- 18.74 PD for type II (p = 0.548). Recession-resection surgery augmented with botulinum toxin A chemodenervation is a concise and effective procedure for treating paralytic horizontal strabismus.