Use of multimodal imaging in diagnosis and treatment planning of traumatic incomplete muscle laceration
Reviewed by Fiona Rowe

This paper discusses details of incomplete rectus muscle lacerations and the unique role of multimodal (local anterior segment optical coherence tomography (ASOCT) and orbital CT/MRI) imaging techniques in the repair of such injuries. This was a retrospective analysis of traumatic rectus muscle injuries in 11 patients. In all, CT / MRI gave the orbital or posterior course of the muscle but no details of the anterior course or location on the sclera. Anterior segment optical coherence tomography supplemented these details and, combined with CT / MRI, a pictorial representation of muscle injury was possible. Patients were a mean age of 31.36 ±14.38 years; four female, seven male; three right eye and eight left injury. Mean duration from trauma to surgery was 5.04 ±4.66 months. Post-penetrating injury was the cause for eight and post adnexal or sinus surgery as the cause for three. Mean preoperative vertical and horizontal angles of deviation were 34.37 ±11.47PD and 39.85 ±30.27PD respectively. The angle reduced postoperatively to 4.62 ±1.40PD and 6.57 ±6.90PD respectively at six months follow-up. Mean preoperative ASOCT measured distance of muscle from the angle was 5.88 ±0.88mm vs the intraoperative confirmed distance of 5.61 ±0.74mm. One case was not surgically explored due to spontaneous improvement. Surgery was required for 10 patients including plication alone or plication with advancement. All had external trauma which severed the muscle in its anterior portion: five isolated inferior rectus, three with inferior and medial recti, two with lateral rectus and one with medial rectus involvement. Use of multimodal imaging facilitated the identification of an incompletely lacerated muscle which informed the treatment approach.

Management of traumatic incomplete lacerating rectus muscle injuries using multimodal imaging approach (ASOCT and CT/MRI).
Pujari A, Rathod A, Hounica B, Khokhar S.
STRABISMUS
2024;32(4):230–42.