Yao Z, Jiang WL, Yang X. Yokoyama procedure for a woman with heavy eye syndrome who underwent multiple recession-resection operations: A case report. World J Clin Cases 2022; 10(31): 11517-11522 [PMID: 36387826 DOI: 10.12998/wjcc.v10.i31.11517]
Corresponding Author of This Article
Xian Yang, MD, PhD, Professor, Department of Ophthalmology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266003, Shandong Province, China. yangxian_zhao@qdu.edu.cn
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2022; 10(31): 11517-11522 Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11517
Yokoyama procedure for a woman with heavy eye syndrome who underwent multiple recession-resection operations: A case report
Zong Yao, Wen-Lan Jiang, Xian Yang
Zong Yao, Wen-Lan Jiang, Xian Yang, Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Author contributions: Zong Y and Yang X were the patient's surgeon; Zong Y contributed to the conception, manuscript writing, revision, and final approval of manuscript; Jiang WL contributed to the provision of study materials; Yang X contributed to the design, manuscript writing and revision, and final approval of manuscript.
Supported bythe Natural Science Foundation of Shandong Province, No. ZR2018BH013; the China Postdoctoral Science Foundation, No. 2017M612214.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian Yang, MD, PhD, Professor, Department of Ophthalmology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266003, Shandong Province, China. yangxian_zhao@qdu.edu.cn
Received: May 19, 2022 Peer-review started: May 19, 2022 First decision: August 4, 2022 Revised: August 14, 2022 Accepted: August 30, 2022 Article in press: August 30, 2022 Published online: November 6, 2022 Processing time: 160 Days and 19 Hours
Abstract
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.
Core Tip: In highly myopic patients, excessively long axial length can cause a type of myopia-induced strabismus, characterized by progressive esotropia and hypotropia, which means the enlarged globe displace between the superior rectus and lateral rectus muscles. In this case report, a woman had been misdiagnosed with simple esotropia and had undergone three recession-resection surgeries with no improvement. We performed a Yokoyama procedure, and her eyes remained binocularly aligned for 6 mo postoperatively.
