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Biomedical subjects

W de Decker

Publications and source records attributed to W de Decker.

At least 19 recordsLinked to original sources
PubMed1999

Stereoacuity and aniseikonia after unilateral and bilateral implantation of the Array refractive multifocal intraocular lens.

PURPOSE: To evaluate stereoacuity and aniseikonia in eyes with unilateral and bilateral implantation of the Allergan Array refractive multifocal intraocular lens (MIOL). SETTING: Department of Ophthalmology, University Hospital, Kiel, Germany. METHODS: This study comprised 31 patients with a unilateral MIOL and a phakic fellow eye and 29 patients with bilateral MIOLs. In all pseudophakic eyes, an Array MIOL had been implanted between 1991 and 1994 during a prospective clinical trial. In the present study, patients were re-examined. Near and distance visual acuity were tested; binocular functions were assessed using Bagolini lenses, the Worth 4-dot test, the Lang random-dot test, and the Titmus fly chart. Aniseikonia was evaluated using Aulhorn's phase-difference haploscope. Mean follow-up was 43 months in both groups. RESULTS: After unilateral implantation 87.1% of patients and after bilateral implantation 93.1% of patients correctly perceived the stereograms of the Lang random-dot test. The mean subjective height of the measured Titmus fly was 4.2 cm after unilateral and 4.3 cm after bilateral implantation. The stereoacuity tests revealed no statistically significant differences between the groups. Distance and near aniseikonia were significantly less after bilateral than after unilateral implantation. CONCLUSION: Despite the simultaneous formation of multiple retinal images, the Array MIOL allowed good binocular vision including random-dot stereopsis. Functional aniseikonia developed but did not interfere with normal binocular vision.

Aged↗
PubMed1999

[Neglected constrained head posture in early childhood strabismus].

BACKGROUND: About 2% of the patients with an early-onset esotropia reveal a severe head tilt, of which about 80% tilt their head towards the side of the dominant eye. This is an abnormal posture without a profit for the patient, needing a torsional shift operation. A minority (20%) tilt to the side of the non-dominant eye, while presenting with a severe and unilaterally pronounced DVD. Once the DVD is really bilateral in terms of clinical aspects, patients have a tendency to give in preferring a consistent upgaze position. PATIENTS: Within 73 patients operated here for DVD (1995-1998) 19 showed the first and 10 the second here described head position. RESULTS: One of the first group (tilt) failed, while all the others had improvements of their postures, always to the degree of a socially acceptable appearance. CONCLUSION: A marked Faden operation on the superior rectus muscle of the elevating eye, occasionally bilaterally (in 2 cases of the upgaze-group) is a very rewarding procedure, much more than the "torsional Kestenbaum" in cases who tilt to the dominant side.

Adolescent↗
PubMed1998

[Improved fixation of unilateral suture operation of the rectus medialis muscle of the amblyopic eye].

BACKGROUND: Strabismus surgery influences the retinal fixation positively, as described by Böhme, Ehrich and Cüppers. Fadenoperation (Posterior Fixation) of the medial rectus muscle allows a more specific approach. It reduces the influence of overadduction and latent-type nystagmus on the retinal fixation, which becomes more central and more controlled after such an operation. PATIENTS: This effect is very marked in infants up to 2 years of age, but still significant in older children with intolerance for occlusion, and motility-dependent excentric fixation. About half of the 70 cases observed reached a useful fixation and acuity by "surgical pleoptics". With respect to the otherwise poor prognosis of these cases, this result can be regarded as favourable.

Amblyopia↗
PubMed1995

[Effect of traumatic iris defects on spatial perception].

Perforating injury to the eye often results in iris defects in addition to loss of the lens. To determine whether iris defects can impair stereopsis, we tested the stereoscopic vision of 23 patients treated at the University Eye Clinic in Kiel for perforating eye injuries involving the iris and, in most cases, the lens. The patients were divided into three groups according to the severity of the iris defect and the status of the intraocular lens. Individuals with strabismus or visual acuity < 0.5 (20/40) were excluded. Stereopsis was measured using conventional stereopsis tests (Titmus contour stereopsis, Lang global stereopsis) and by means of the Pulfrich pendulum phenomenon. Patients with traumatic aphakia without an iris defect (n = 33) served as controls. Optical rehabilitation was achieved in the controls lenses (n = 16) or intraocular lens implant (n = 17). In group I (intact lens, iris defect < 135 degrees), two of five patients had attained global stereopsis. In group II (implanted or contact lens, iris defect < 135 degrees), only one of the nine patients exhibited global stereopsis. In group III (no lens, iris defect > 135 degrees), none of the nine patients achieved global stereopsis. In the control group, by contrast, more than half of the patients with an implant (10 of 17) and 3 of 16 patients with a contact lens attained global stereopsis. The results indicate that severe iris defects are especially likely to impair stereoscopic vision, more so than traumatic loss of lens alone without an accompanying iris defect.

Adolescent↗
PubMed1990

[Visual acuity and binocular vision following surgery of extreme retinal detachment].

Retinal surgery with implantation of silicone oil was performed in 33 patients presenting with idiopathic or traumatic proliferative vitreoretinopathy. Following removal of the oil patients were on average followed-up for 6 to 29 months (14 months). Sixteen patients had had buckling procedures prior to endosurgery. Improvement of vision up to 4 rows of optotypes was noted in 21 patients following silicone oil removal. Three cases showed a large, organic, central scotoma. Ten patients suffered from diplopia; 3 of whom were known to have had a preexisting strabismus. Suppression of the visual impression of the operated eye was seen in 4 cases. Eye muscle surgery was necessary in 4 cases. Sixteen patients demonstrated normal binocular vision as far as possible taking the visual acuity into account.

Adolescent↗
PubMed1988

Unilateral medial rectus resection in the treatment of small-angle exodeviation.

Twenty-six patients with small-angle constant or intermittent exotropia of up to 7 degrees, and eight patients with small-angle exophoria of the convergence-insufficiency type, underwent unilateral medial rectus resection. Of the 34 patients, 9 were cured, 19 improved and in 6 surgery failed or there was early recurrence. Improvement occurred usually in patients who had basic microexotropia and in some who had homonymous abnormal retinal correspondence, a factor which limited the sensory results. The sensory, motor, and mechanical factors influencing the procedure are discussed in detail. The resection technique employed is reviewed, demonstrating the advantage of well-controlled results. This paper shows that resecting the medial recti is useful, not only in convergence insufficiency, but also in related small-angle exodeviations, for which a classification is proposed.

Adolescent↗
PubMed1988

[Torsional shift operation, a tool in complete early childhood strabismus].

By means of torsional shift operation, or "rotatory Kestenbaum procedure" - in which both ocular bulbs are rotated to the side to which the head is inclined - head malpostures can be eliminated or alleviated in three out of four cases. This applies both to the smaller group of patients with true nystagmus compensation as well as to the large group with "tilt" as a part-symptom of Lang's early-onset strabismus syndrome. The procedure for all four oblique muscles is described in detail, including the strategies for preventing side effects. The results of 98 operations are presented in tabular form. Additionally, the authors describe on the basis of case histories how to apply and modify the procedure when other typical, severe symptoms of early-onset strabismus syndrome require surgical correction. The discussion considers facts and hypotheses relating to the pathophysiological background.

Adolescent↗
PubMed1986

[The syndrome of enlarged orbits].

Combined orbital fractures cause hematomas and subsequent rigidity of the ligament apparatus around the inferior rectus muscles, while the few true blow-out fractures may lead to an adherence of connective tissues to the floor. The authors describe a third mechanism: Enlargement of the orbit impairs motility, especially the elevation of the globe: Diagnostic pressing of the orbital, parabulbar contents improves elevation. In 9 such cases that were free of the two other knows mechanisms motility was improved by reducing orbital volume. This was performed by implants (4 cases), by instillation of hydroxylapatite (4 cases) or by re-resection of the bony frame (1). Subsequent muscle surgery, if at all necessary, gave truly satisfactory results.

Collagen↗
PubMed1983

Constant or apparently constant congenital esotropia? A survey of 304 Fadenoperations.

Cüppers (6) presented the Fadenoperation (Fd) as a splendid tool to correct inconstant squint angles by means of an artificial paresis. The author's practice shows that many cases of apparently constant congenital esotropia, successfully treated by Fd, obviously would be better interpreted as permanently overinnervated adduction excess cases. But even a sophisticated view of the mechanism of the Fd cannot solve the problem of whether or not a stable basic angle really exists in children before the age of five years. The paper, in addition, deals with the results of 304 cases of alternating congenital esotropia and the author's own techniques.

Child, Preschool↗
PubMed1982

[Catalog of direct eye muscle injuries].

Eye muscle injuries may occur in isolation or concomitantly with orbital fractures. Depending on their mechanical cause they may be encountered in the form of contusions, overextensions or injuries caused by stabbing or cutting. The authors present case histories from their own patient collective in this order, supplemented by a number of cases described in the literature. Particular attention is paid to the superior oblique, injuries to which are almost without exception trochlear or pretrochlear. The special anatomy of the tendon is a factor that may explain restrictions in motility in upward and downward gaze (dysfunctions). Certain severe cases are described and the principles of reconstructive surgery are discussed.

Adult↗
PubMed1981

[Kestenbaum transposition for treatment of retraction syndrome (author's transl)].

In pronounced forced attitude in consequence of retraction syndrome, abduction capacity with good head posture can be attained by Kestenbaum transposition. The advantages are in the retention of the motility present, with a more favorable distribution. At the same time, an exophoria for the previously most favorable glance direction is avoided. Proportioning must be small because of the stiffness of the muscles (4 to 6 mm). In less pronounced cases, the indication is not quite so convincing. Proportioning and problems arising from the stiffness of the muscles are briefly discussed. Where strabismus verus is also present squint operations and transpositions should be performed in separate sessions.

Adult↗