In vivo experimental study on the resistance and stiffness of orbital suspension tissues with/without the extraocular muscles

Background: The accuracy of the surgical amount of extraocular muscle (EOM) is key to the success of strabismus surgery. To establish an accurate eye movement model, it is of great theoretical value and clinical significance to determine the surgical amount of EOM. At present, only resistance and stiffness data of orbital suspension tissues with EOMs exist, while those of orbital suspension tissues without EOMs, which is critical information for eye movement modeling, have not been reported. The aim of this research is to study the resistance and stiffness of orbital suspension tissues with/without EOMs. Methods: Fifteen healthy New Zealand white rabbits with body weights of 2.41 +/- 0.13 kg were used in the study. Two recti (two horizontal recti of the left eye or two vertical recti of the right eye) or all EOMs were detached from each eye under general anesthesia. Then, a 5-0 silk suture was attached to the stump of the detached rectus insertion (two horizontal recti insertions of the left eye and two vertical recti insertions of the right eye) on the isolated eyeball. The 5-0 silk suture was connected to the INSTRON 5544 tester to facilitate the horizontal rotations of the left eyes and the vertical rotations of the right eyes, respectively. Results: The resistance and stiffness of orbital suspension tissues with superior rectus, inferior rectus, superior oblique, and inferior oblique EOMs were obtained during horizontal eye movement. Similarly, the resistance and stiffness of orbital suspension tissues with lateral rectus, medial rectus, superior oblique, and inferior oblique EOMs were obtained during vertical eye movement. Then, the resistance and stiffness of orbital suspension tissues without EOMs were obtained during horizontal and vertical eye movements. The resistance and stiffness data of orbital suspension tissues with EOMs were compared with those of orbital suspension tissues without EOMs. The comparison results showed no significant difference in the resistance values between these two cases. In addition, the stiffness values of these two cases statistically differed. Conclusions: The two horizontal recti play a major role in passive horizontal eye movement. In addition, when the eye is passively moved vertically, the two vertical recti play major roles. The stiffness of orbital suspension tissues with EOMs, which has been used in eye movement modeling, is not accurate. The results of this work may serve as a reference for improving the accuracy in eye movement modeling, and then it will be beneficial for determining the surgical amount of EOMs in clinical surgery.