Author(s): Siam AL, ElMamoun TA, Ali MH
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Abstract PURPOSE: To study the anatomy of the posterior aspect of the globe comparing it with previous textbook descriptions, to find constant anatomical landmarks for macular buckling surgery. DESIGN: This is an anatomical study on cadaver eyes with additional in vivo measurements during the macular buckling procedure. METHODS: Twelve cadaver eyes were carefully dissected identifying important structures on the posterior aspect of the globe and measuring their cross-diameters and relative distances. The distance of the medial end of inferior oblique insertion from the foveal position projected on the scleral surface and the border of the optic nerve sheath were measured. The intrascleral course of temporal long posterior ciliary artery was identified and measured, and its distance from the optic nerve sheath was also measured. RESULTS: The macula consistently lies on the horizontal meridian (foveal horizontal meridian) defined by the course of the long posterior ciliary arteries, which cross the optic nerve somewhere between its center and its lower border. CONCLUSION: The horizontal meridian (foveal horizontal meridian), defined by the entry site and course of the long posterior ciliary arteries, serves as an important surgical landmark if precise external scleral buckling of the fovea is the objective. For practical purposes, foveal horizontal meridian, geometrical horizontal meridian, and optic nerve horizontal meridian need to be distinguished.
This article was published in Retina
and referenced in Journal of Clinical & Experimental Ophthalmology