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Biomedical subjects

M H Gobin

Publications and source records attributed to M H Gobin.

At least 19 recordsLinked to original sources
PubMed1994

[The Leiden school].

Simultaneous horizontal and cyclovertical surgery gives better results than pure horizontal surgery; not only binocular vision reappears immediately and spontaneously but the accommodative component of the squint disappears as well. The question is to know why simultaneous surgery gives such good results. We think that the reduction of the vertical deviations associated with horizontal strabismus may give an explanation. In our experience, a vertical deviation is often present in accommodative strabismus and can disrupt fusion. The hemiretinal suppression which follows, puts the vergence system into open loop. The accommodative vergence caused by hypermetropia becomes manifest so that the correction needs to be reinforced frequently. In a young child this may impede the emmetropisation process. In addition, the spectacles being associated with strabismus, may be the source of psychological complexes. The fact that the squint is not cured and the deviation reappears without spectacles gives us the right to look for a more adequate remedy. The good results we obtained with simultaneous horizontal and cyclovertical surgery and especially the disappearance of the accommodative element encouraged us to operate accommodative strabismus.

Accommodation, Ocular↗
PubMed1992

[Photographic screening for amblyopia, strabismus and refraction errors].

The authors present a photographical method to screen infants on the presence of refractive errors and squint. The photoscreener indicates an absence of focusing in one or both eyes and/or a squint. This method can be used in mass-screening of siblings, the evaluation of glasses, the monitoring of the effects of occlusion and the postoperative follow-up of patients.

Amblyopia↗
PubMed1982

[Results of simultaneous horizontal and cyclovertical surgery in esotropia].

The authors treat esotropia by simultaneous horizontal and cyclo-vertical surgery. Horizontal surgery consists of recession of both medial rectus muscles and cyclo-vertical surgery of desagittalization of the oblique muscles combined, if necessary, with a weakening of a vertical rectus muscles. Techniques and indications of this surgery are discussed and analysis made of the results of 785 cases treated with 960 operations. According to this analysis the surgical indications are adapted to this procedure.

Amblyopia↗
PubMed1981

Surgical treatment of the A and V phenomena.

Our surgical treatment of the A and V phenomena consists of a systematic combination of oblique and horizontal muscle surgery. The oblique muscles are desagittalized: the plane of action of the muscle is displaced forwards so that its angle with the visual axis enlarges. The vertical action of the oblique muscle is thus reduced in favour of the torsional action. This desagittalization is always performed bilaterally and combined with a bilateral recession of a rectus muscle: the medial rectus muscles in cases of esotropia and the lateral rectus muscles in cases of exotropia. A real vertical deviation (RVD), if present, is treated by asymmetrical oblique muscle surgery or by the weakening of a vertical rectus muscle. In cases of under- or overcorrection a remaining diagonal and vertical deviation is carefully searched for and dealt with. In addition, a horizontal undercorrection is treated by placing a secondary loop on the already recessed medial rectus muscle, and a horizontal overcorrection is treated by weakening both lateral rectus muscles.

Child↗
PubMed1981

[New view points on the pathogenesis and treatment of strabismus. 2nd part: Management of strabismus (author's transl)].

A new method of surgical treatment of strabismus is presented. The desagittalisation of the oblique muscles is the main part of surgery; it is associated to surgery of the horizontal recti muscles and sometimes to surgery of the vertical recti muscles. The surgical procedures are described; the indications are set up for the primary surgery as well as for the secondary surgery which aims at the treatment of under and over corrections.

Adult↗
PubMed1981

[New viewpoints on the pathogenesis and the treatment of strabismus. 3rd part: management of strabismus (author's transl)].

The major complications of our surgery such as the duction limitations, the postoperative diplopia, the vicious cicatrices and the modifications of the palpebral fissure are considered in this article. The cause, diagnosis and treatment are discussed. In the conclusions the value of our two keys is commented on, the importance of our maximal and atraumatic surgery is stressed and the problem of delayed over-corrections is mentioned.

Cicatrix↗
PubMed1980

[New viewpoints on the pathogenesis and the treatment of strabismus. First part: pathogenesis of strabismus (author's transl)].

In 1962 the anteroposition of the inferior oblique muscle has been introduced. This surgery enlarges the angle between the muscle and the visual axis favouring the torsional action at the cost of the vertical one. The results of 554 cases with a postoperative follow-up of at least ten years are analysed. The spontaneous recovery of binocular vision and the disappearance of the accommodative component suggest that a sagittalization of the oblique muscles might be an important cause of strabismus. The evolution of the suppression scotoma demonstrates that the position of the eyes depends on the optomotor balance between the nasal and temporal retinal halves. A new concept of the pathogenesis of squint is presented. The sagittalization of the oblique muscles and the hemiretinal suppression are considered to be the keys by means of which the problem of strabismus could be solved.

Adult↗
PubMed1977

Desinsertion of the superior oblique in A-patterns.

A-patterns have been treated by various techniques, with variable results. A desinsertion of the superior oblique at its insertion temporal to the superior rectus has proved to be a satisfactory treatment. This is combined with horizontal surgery. The results of this surgery in 137 cases are analysed and the complications outlined.

Humans↗