Pterjium cerrahisi sonrası gelişen bilateral ekzotropya: Olgu sunumu

52 yaşında kadın hastada bilateral pterjium cerrahisi sonrası gelişen bilateral ekzotropyanın değerlendirilmesi ve bunun medial rektus kası ilerletilmesi ve sağ kas transpozisyonu ile tedavisi sunulmuştur. Hastanın otogreftli pterjium operasyonu sonrası muayenesinde sağ gözde adduksiyon hiç yoktu, sol gözde ise adduksiyon kısıtlı idi. Primer yukarı -aşağı bakış yönlerinde diplopi mevcuttu. Orbital ve Manyetik Rezonans görüntülemesi normaldi. Hastaya bilateral medial rektus ilerletilmesi girişimi planlandı ancak operasyon sırasında sağ medial rektus kası bulunamadığından sağ kas transpozisyonu ve sol medial rektus kasına ilerletme operasyonu yapıldı. Pterjium cerrahisi sonrası diplopi ile beraber inkomitant ekzotropya varlığı cerrahi sırasında oluşan medial rektus kas zedelenmesi ihtimalini akla getirmeli ve pterjium cerrahisi tecrübesiz ellere bırakılmamalıdır

Bilateral exotropia following pterygium surgery: Case report

We present an evaluation of a bilateral exotropia case following a bilateral pterijium surgery that was treated by medial rectus muscle advancement and right muscle transposition in a 52-year-old women. At the examination performed after pterygium surgery with autograft, adduction in the right eye was lost and in the left eye was restricted. Diplopia was revealed in the primary up-down direction of gaze position. Orbital and magnetic resonance imaging was normal. Bilateral medial rectus advancement was planned but because of right medial rectus muscle was not found during the operation, right muscle transposition and left medial rectus muscle advancement operations were performed. The presence of an incomitant exotropia with diplopia immediately after pterygium surgery should alert us to the possibility of having injured the medial rectus during the surgery and the surgery of pterygium should not be left in unexperienced hands. J Clin Exp Invest 2014; 5 (3): 456-458

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