Cataract surgical problem: response #6
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Journal Article↗
Biomedical subjects
GU Auffarth
Publications and source records attributed to GU Auffarth.
Posterior fixation suture and convergence excess esotropia.
The present study investigates the results of Cuppers' 'Fadenoperation' in patients with non-accommodative convergence excess esotropia. Particular attention is given to postoperative eye alignment at distance fixation. Group 1 (n=96) included patients with a 'normal' convergence excess. The manifest near angles (mean ET 16.73 degrees +/- 6.33 degrees, range 4 degrees -33 degrees ) were roughly twice the size of the distance angles (mean ET 6.50 degrees +/- 3.62 degrees, range 0 degrees -14 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti without additional eye muscle surgery. Three months after surgery, the mean postoperative angles were XT 0.5 degrees +/- 3.3 degrees (range XT 11 degrees -ET 5 degrees ) for distance fixation, and ET 2.7 degrees +/- 3.6 degrees (range XT 5 degrees -ET 14 degrees ) for near fixation, respectively. Postoperative convergent angles at near fixation >ET 10 degrees were present in two patients (1.9%). Group 2 (n=21) included patients with a mean preoperative distance angle of ET 9.2 degrees +/- 3.7 degrees (range 6 degrees -16 degrees ) and a mean preoperative near angle of ET 23.4 degrees +/- 3.1 degrees (range 16 degrees -31 degrees ). These patients were operated on with a bilateral fadenoperation of the medial recti and a simultaneous recession of one or both medial rectus muscles. Mean postoperative angles were XT 0.5 degrees +/- 4.6 degrees (range XT 12 degrees -ET 7 degrees ) for distance fixation and ET 1.4 degrees +/- 4.5 degrees (range XT 8 degrees -ET 13 degrees ) for near fixation, respectively. In this group, 2 patients (10.6%) had a postoperative exotropia >XT 5 degrees at distance fixation, and two patients had residual esotropia>ET 10 degrees at near fixation. Group 3 (n=17) included patients with a pronounced non-accommodative convergence excess. Near angle values (mean of 17.8 degrees +/- 5.3 degrees, range ET 7 degrees -26 degrees ) were several times higher than the distance angle values (mean ET 1.9 degrees +/- 4.2 degrees, range XT 3 degrees -ET 6 degrees ). These patients were treated with a bilateral fadenoperation of the medial recti and a simultaneous resection of one or both medial rectus muscles. Mean postoperative angles were ET 0.2 degrees +/- 4.7 degrees (range XT 8 degrees -ET 6 degrees ) for distance fixation and 5.3 degrees +/- 6.1 degrees (range XT 3 degrees -ET 12 degrees ) for near fixation, respectively. One patient had a postoperative distance angle >XT 5 degrees, whereas two patients displayed postoperative convergent angles >ET 5 degrees at near fixation.
Journal Article↗