Disinsertion of the medial rectus following pterygium surgery: signs and management.

The clinical characteristics, intraoperative findings and management of two cases of "lost" medial recti during surgery for recurrent pterygium are described. The lost muscles are classified in different groups according to their etiopathogenesis. In the cases reported, the muscles were found retroinserted with extensive proliferation of fibrous tissue. This complication was resolved after finding the muscle, liberating the surrounding fibrous tissue and reattachment in its original insertion. Two aspects stand out: The CAT scan to determine the location of the muscle and the usefulness of topical anesthesia to facilitate recognition of the muscle during the surgical procedure.