Journal of the Korean Ophthalmological Society 2006;47(5):852-857.
Published online May 31, 2006.
A Case of Congenital Absence of the Inferior Rectus Muscle.
Byung Chun Park, Ju Youn Lee
Department of Ophthalmology, Hallym University, College of Medicine, Chunchun, Korea. ljy690725@hanmail.net
선천 하직근 결손 1예
박병춘,이주연
Department of Ophthalmology, Hallym University, College of Medicine, Chunchun, Korea
Correspondence:  Byung Chun Park, M.D.
Abstract
PURPOSE
To report a patient with isolated congenital absence of the right inferior rectus muscle. To our knowledge, this is the first case reported in Korea. METHODS: A 6-year-old girl presented with an anomalous head posture of 15 degrees head tilt. She had 45delta right hypertropia, 15delta A-pattern exotropia and a marked underaction of the right inferior rectus. At the time of the surgery, forced duction test of the right eye showed no limitation and the inferior rectus muscle was found to be absent. Inferior transposition of the horizontal rectus muscles was more approximated to each other than that described in the classic Knapp operation. This was carried out while the right medial rectus muscle was simultaneously resected 2mm for correction of the exotropia. RESULTS There was significant improvement in infraduction at 6 months postoperative with only a residual 6delta exotropia in primary position. CONCLUSIONS: Absence of the inferior rectus showed hypertropia with A pattern exotropia. It did not bring about contracture of the superior rectus muscle or amblyopia. The outcome of the modified Knapp procedure was satisfactory.
Key Words: Absence;Inferior rectus;Modified transposition


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