{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:41:53Z","timestamp":1791502913230,"version":"4.3.4"},"reference-count":17,"publisher":"SLACK, Inc.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Pediatr Ophthalmol Strabismus"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:p>\n            The authors describe three examples of \u201cpulled in two syndrome\u201d (PITS) from a series of 13 patients undergoing strabismus surgery with underlying chronic progressive external ophthalmoplegia (CPEO) and illustrate techniques for recovery of the \u201cpulled in two\u201d extraocular muscle should the complication arise. In all cases, a rectus muscle snapped under minimal tension while held on a strabismus hook during strabismus surgery. Two patients suffered from CPEO as a result of genetic mitochondrial disease, whereas one resulted from presumed mitochondrial toxicity induced by HAART. In cases 1 and 3, the proximal medial rectus segment was retrieved and reattached. In case 2, the fragmented superior rectus muscle was too friable to be reattached. All three patients were satisfied with the outcome, having reduced their angles of misalignment postoperatively. All three had improved cosmesis, and the two who had complained of diplopia preoperatively found their diplopia to be eliminated or improved. With anticipation of muscle friability in patients with previous extraocular surgery or degenerative muscle changes such as CPEO, the likelihood of the complication arising may be reduced. Should it occur, the loss of a snapped rectus muscle may be avoided through careful manipulation of the globe.\n            <jats:bold>\n              [\n              <jats:italic>J Pediatr Ophthalmol Strabismus<\/jats:italic>\n              . 2017;54:e83\u2013e87.]\n            <\/jats:bold>\n          <\/jats:p>","DOI":"10.3928\/01913913-20171017-01","type":"journal-article","created":{"date-parts":[[2017,11,20]],"date-time":"2017-11-20T20:02:04Z","timestamp":1511208124000},"source":"Crossref","is-referenced-by-count":7,"title":["Surgical Technique for Pulled in Two Syndrome: Three Cases With Chronic Progressive External Ophthalmoplegia"],"prefix":"10.3928","volume":"54","author":[{"given":"Alexander Matthew","family":"Jones","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Starte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpa.2000.103438"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.3109\/08820538.2014.959190"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.1998.tb01436.x"},{"key":"e_1_3_1_5_2","first-page":"116","article-title":"Grand rounds #50: a case of a lost medial rectus muscle in an eye in which the inferior rectus muscle \u201cpulled in two.\u201d","volume":"13","author":"Kushner BJ","year":"1998","unstructured":"Kushner BJ, Sprunger DT, Saunders RA, et al. Grand rounds #50: a case of a lost medial rectus muscle in an eye in which the inferior rectus muscle \u201cpulled in two.\u201d Binocul Vis Strabismus Q. 1998;13:116\u2013123.","journal-title":"Binocul Vis Strabismus Q"},{"key":"e_1_3_1_6_2","first-page":"41","article-title":"Successful extraocular muscle re-resection for a strabismus surgery complication: a \u201csnapped\u201d [severed, inadvertently] and retrieved inferior rectus muscle: a case report","volume":"271","author":"Akbari MR","year":"2012","unstructured":"Akbari MR, Jafari AK, Ameri A, Anvari F, Eshraghi B, Masoomian B. Successful extraocular muscle re-resection for a strabismus surgery complication: a \u201csnapped\u201d [severed, inadvertently] and retrieved inferior rectus muscle: a case report. Binocul Vis Strabolog Q Simms Romano. 2012;271:41\u201345.","journal-title":"Binocul Vis Strabolog Q Simms Romano"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-8531(97)90061-6"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.76.3.131"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpa.2001.111014"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-016-0652-7"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2012.08.005"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181aae814"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1086\/591202"},{"key":"e_1_3_1_14_2","volume-title":"Walsh & Hoyt's Clinical Neuro-Ophthalmology","author":"Miller NR","year":"2005","unstructured":"Miller NR, Newman NJ, Kerrison JB, Aminoff MJ, Daroff RB. Walsh & Hoyt's Clinical Neuro-Ophthalmology, 6th ed., vol. 25. Philadelphia: Lippincott Williams & Wilkins; 2005.","edition":"6"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2006.04.012"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejhg.5201216"},{"key":"e_1_3_1_17_2","first-page":"375","article-title":"An overview of mutation detection methods in genetic disorders","volume":"23","author":"Mahdieh N","year":"2013","unstructured":"Mahdieh N, Rabbani B. An overview of mutation detection methods in genetic disorders. Iran J Pediatr. 2013;23:375\u2013388.","journal-title":"Iran J Pediatr"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.77126"}],"container-title":["Journal of Pediatric Ophthalmology &amp; Strabismus"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.healio.com\/doiresolver?doi=10.3928\/01913913-20171017-01","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T23:18:23Z","timestamp":1683069503000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/01913913-20171017-01"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.3928\/01913913-20171017-01"],"URL":"https:\/\/doi.org\/10.3928\/01913913-20171017-01","relation":{},"ISSN":["0191-3913","1938-2405"],"issn-type":[{"value":"0191-3913","type":"print"},{"value":"1938-2405","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11]]}}}