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Results for “Strabismus”

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At least 433 records · Page 24Linked to original sources

PubMed2003

Genome-wide search for strabismus susceptibility loci.

The purpose of this study was to search for chromosomal susceptibility loci for comitant strabismus. Genomic DNA was isolated from 10mL blood taken from each member of 30 nuclear families in which 2 or more siblings are affected by either esotropia or exotropia. A genome-wide search was performed with amplification by polymerase chain reaction of 400 markers in microsatellite regions with approximately 10 cM resolution. For each locus, non-parametric affected sib-pair analysis and non-parametric linkage analysis for multiple pedigrees (Genehunter software, http://linkage.rockefeller.edu/soft/) were used to calculate multipoint lod scores and non-parametric linkage (NPL) scores, respectively. In sib-pair analysis, lod scores showed basically flat lines with several peaks of 0.25 on all chromosomes. In non-parametric linkage analysis for multiple pedigrees, NPL scores showed one peak as high as 1.34 on chromosomes 1, 2, 4, 7, 10, 15, and 16, while 2 such peaks were found on chromosomes 3, 9, 11, 12, 18, and 20. Non-parametric linkage analysis for multiple pedigrees of 30 families with comitant strabismus suggested a number of chromosomal susceptibility loci. Our ongoing study involving a larger number of families will refine the accuracy of statistical analysis to pinpoint susceptibility loci for comitant strabismus.

Adolescent↗

PubMed2006

Intraoperative adjustment in strabismus surgery under topical anesthesia.

We evaluated the one-stage intraoperative adjustment strabismus surgery with adjustable suture under topical anesthesia. Medical records of the patients who had intraoperative adjustment surgery under topical anesthesia for horizontal or vertical strabismus in our hospital from March 1997 to March 2003 with follow-up of 6 months were analyzed retrospectively. Of the 71 patients, 48 patients had exotropia, 16 had esotropia, and 7 had hyper- or hypotropia. The overall success rates were 85.9% at 1 week, 83% at 1 month, 78.9% at 3 months, and 76.1% at 6 months after surgery. The procedure was not stopped in any patients, and no serious intra-operative or postoperative complications were noted. Intraoperative adjustment strabismus surgery under topical anesthesia is a simple, well-tolerated and effective procedure.

Administration, Topical↗

PubMedDate not supplied

Studies on visual evoked cortical response by liquid crystal phase difference haploscope: amblyopia and/or strabismus.

Visual evoked cortical potentials induced by alternate stimulation of checkerboard pattern with the use of liquid crystal phase difference haploscope were investigated. The synchronization ratio of brain response was determined both in the group of normal binocularity and in the group with binocularity defect. The synchronization ratio of the group of normal binocularity (N = 30) is 100% at 1 Hz x 2, 98.5% +/- 3.9% at 5 Hz x 2, and 83.7% +/- 15.8% at 10 Hz x 2. On the other hand, in the group with binocularity defect, strabismus without amblyopia shows a reduction of the ratio only at the frequency of 10 Hz x 2. Anisometropic amblyopia shows a significant reduction of the ratio at 10 Hz x 2 and strabismus with amblyopia shows a remarkable reduction at 5 Hz x 2 and 10 Hz x 2. As for strabismus with or without latent binocularity, the latter cases show a significant reduction of the synchronization ratio. The reduction of synchronization ratio of VECP seems to have some relationship to the binocularity.

Adolescent↗

PubMedDate not supplied

Adjustable suture strabismus surgery.

We examined 333 patients between the ages of 11 and 70 years who underwent strabismus surgery with adjustable sutures over a ten-year period. The type of strabismus, the number and amount of adjustments, the postoperative drift, and complications were evaluated. A large percentage of patients required adjustment to obtain the desired postoperative position. The postoperative drift patterns were characteristic for each type of preoperative deviation and were similar to that reported for nonadjustable procedures. Adjustable suture techniques were especially helpful in selected horizontal deviations, vertical deviations, and the more complex strabismus problems. The complications from adjustable suture operations in this series were minimal.

Adolescent↗

PubMedDate not supplied

Long-term strabismus complications following retinal detachment surgery.

Thirty-three consecutive patients with persistent strabismus following retinal detachment surgery were studied retrospectively. A large number of vertical and torsional problems were seen. Various restrictive abnormalities were identified during strabismus surgery. These included superior oblique tendon displacement anteriorly, leash and reverse leash types of restrictions, myoscleral adhesions posterior to the exoplants, and stretching of the muscles induced by large underlying exoplants. The results following strabismus surgery were analyzed. Eighty percent of the patients were able to achieve single binocular vision in the primary field of gaze, with a low incidence of complications. The adjustable suture procedure was thought to be helpful.

Adult↗

PubMedDate not supplied

Reoperation rate in adjustable strabismus surgery.

Adjustable suture strabismus surgery may reduce the frequency of reoperations by reducing immediate postoperative over- and undercorrections. We reviewed 290 strabismus procedures performed with an adjustable suture technique. Thirty-five patients required additional surgery, for a reoperation rate of 9.7%. Reoperation frequencies for patients undergoing non-adjustable procedures average approximately 20% in our experience and in reported series. Our low reoperation rate with adjustable strabismus surgery supports our clinical impression that more accurate results are possible with this technique in appropriate patients.

Adolescent↗

PubMedDate not supplied

Strabismus fixus convergens secondary to amyloidosis.

Strabismus fixus convergens is a condition in which both eyes become fixed in extreme adduction. It can be congenital or acquired. We report a case of strabismus fixus convergens in a high myope with primary amyloidosis localized to the lateral rectus muscle. To our knowledge, this is the first report of a case of strabismus fixus convergens secondary to amyloidosis.

Amyloidosis↗

PubMedDate not supplied

Cyclic strabismus without binocular function.

Various forms of cyclic strabismus have been described. A cyclic variation in binocular function modifying a tendency to strabismus is said to be the underlying mechanism. Cyclic esotropia developed in two adult patients, one having no demonstrable binocular function and the other having suffered complete unilateral visual loss in the affected eye. In each case, on the "good days" there was still a manifest esotropia, in contrast to those patients with cyclic esotropia and good binocular function in which the eyes are straight on the "good days." The presence of binocular function is not required for the development of cyclic strabismus, although the level of binocular function is correlated with the ocular alignment on the "good days."

Adult↗

PubMedDate not supplied

Strabismus surgery in patients with myasthenia.

The efficacy of eye muscle surgery for strabismus in patients with myasthenia is not well-documented in the literature. We reviewed the results of strabismus surgery in six patients with the confirmed diagnosis of myasthenia. Patients selected for surgery had angles of deviation that were stable for at least 5 months preoperatively. Patient age ranged from 4 to 62 years. All patients were exotropic. The four adults had moderate limitation of adduction. Surgery included horizontal rectus muscle recession and/or resection in all cases. Three cases involved additional surgery of the vertical rectus or superior oblique muscles. The mean postoperative follow up was 44 months with a minimum of 7 months. Three adults and one child achieved stable satisfactory alignment after one procedure. One child required three procedures to achieve satisfactory alignment. The results suggest that surgery is a viable option in the management of strabismus in selected patients with myasthenia.

Adult↗

PubMedDate not supplied

Mitomycin in the treatment of hypertrophic conjunctival scars after strabismus surgery.

A recognized complication of strabismus surgery is the development of hypertrophic conjunctival scars over the operated-on muscle. Our standard treatment of these scars has been excision followed by corticosteroid eye drops, which results in a scar recurrence rate of 33%. Antimetabolic chemotherapeutic agents, such as mitomycin, can reduce posttraumatic scarring and vascularization of the ocular surface. We studied the use of mitomycin eye drops as an adjunct to standard treatment of hypertrophic conjunctival scars after strabismus surgery. Four patients were treated with adjunct mitomycin eye drops (0.2 to 0.4 mg/ml). Postoperative follow up ranged from 16 to 56 weeks. None of these cases showed significant scar recurrence. Mitomycin in the higher dosage caused mild superficial punctate keratitis after 8 days of use. Despite a lamellar sclerectomy in a patient treated with 0.2 mg/ml of mitomycin, there was no further clinically apparent loss of scleral tissue. The results of this pilot study suggest that topical mitomycin is a safe and effective adjunct to excision and corticosteroid eyedrops in the treatment of hypertrophic conjunctival scars after strabismus surgery.

Administration, Topical↗

PubMedDate not supplied

Evaluation of mitomycin to limit postoperative adhesions in strabismus surgery.

BACKGROUND: Ocular motility dysfunction following strabismus surgery may be the result of postoperative scarring or the formation of adhesions. Mitomycin C (MMC) has been used with encouraging results as an adjunct to standard treatment of hypertrophic conjunctival scars after strabismus surgery. It has been demonstrated that MMC does not inhibit muscle reattachment and might inhibit adhesions and scar formation in the rabbit. We investigated in a rabbit model effectiveness of MMC in reducing the formation of postoperative adhesions following reoperations and the tensile strength of the new musculo-scleral junction. METHODS: A prospective, masked-observer, controlled study was performed in rabbits. Symmetrical bilateral recessions of the superior and inferior rectus muscles were performed on each rabbit. A reoperation was performed 6 weeks later, in which the muscles were advanced back to their original insertion. During the reoperation, one eye served as the control while the other was treated with a 5-minute intraoperative exposure to topical mitomycin. RESULTS: Mitomycin reduced the formation of adhesions and the amount of postoperative scarring. The tensile strength of the musculo-scleral junction was reduced in the mitomycin-treated eyes but exceeded the force generated during extraocular ductions. CONCLUSION: MMC may be an effective adjunctive therapy in the treatment of strabismus associated with pre-existing adhesions or scarring.

Animals↗

PubMedDate not supplied

Tensile strength of insertional suture techniques in strabismus surgery.

BACKGROUND: The "lost" extraocular muscle is a serious adverse outcome of seemingly uncomplicated strabismus surgery. One potential cause of this complication is suture slippage in the operated muscle or tendon. The purpose of this study was to determine the relative tensile strengths of three suture techniques commonly used in strabismus surgery and to compare the incidence of suture slippage in the tendon or muscle among these techniques. METHODS: The horizontal rectus muscles of 18 adults pigs were assigned to undergo either recession or resection and were randomized to one of three suture techniques studies. Tension applied to the free ends of the suture was incrementally increased until failure occurred. The two techniques were compared in terms of the mean applied tensions at the time of failure and the incidence of slippage. RESULTS: No statistically significant difference in mean tension at failure between the three techniques used in recessed or resected muscles was found. Suture slippage in the tendon or muscle occurred in 25% of the trials and was almost evenly distributed among the techniques. Mean tension at slippage did not differ significantly between the techniques. No failure of any kind occurred at less than 100 g applied tension. CONCLUSION: Each suture technique appeared to adequately secure to tendon or muscle for recession and resection procedures. Changing techniques is unlikely to alter the incidence of lost muscles in strabismus surgery.

Animals↗

PubMedDate not supplied

Subjective and objective outcomes of strabismus surgery in children.

BACKGROUND: The negative psychosocial impact of strabismus in adults has been well documented. Despite the increasingly recognized importance of outcomes research, parents' satisfaction with strabismus treatment in childhood and their assessment of its functional impact and "quality of life" impact have not been investigated. METHODS: A survey instrument was designed to assess parents' perceptions of preoperative, surgical, and postoperative phases of the clinical experience, including the long-term impact of surgery on their children. RESULTS: Overall satisfaction with the surgical result was rated "good" or "very good" in 85% of 77 children under age 6. The correlation between subjective satisfaction and objective alignment within 10 prism diopters (delta) of orthophoria was significant (P < .001). Parents of children under age 4 noted improved eye contact (61%) and appearance (94%). Parents of older children noted improved interactions with others (47%) and self-esteem (55%). Coordination was considered improved in 56% of the entire group. Subjective satisfaction and psychosocial benefits often occurred even in cases deemed objectively unsuccessful. CONCLUSION: Surgical correction of strabismus in childhood is clearly perceived by parents to be both successful and important to them and their children.

Child↗

PubMedDate not supplied

A comparison of prophylactic ondansetron hydrochloride and droperidol for strabismus repair in adults.

BACKGROUND: Prophylactic administration of an antiemetic is a common procedure for patients undergoing strabismus surgery. Droperidol and ondansetron hydrochloride are commonly used antiemetics. This study compared the rates of postoperative nausea and vomiting (PONV) in adult patients undergoing strabismus surgery with prophylactically administered Droperidol or ondansetron hydrochloride. METHODS: A double-masked, randomized, prospective study was conducted comparing droperidol with ondansetron hydrochloride when administered prophylactically to adults undergoing strabismus surgery. RESULTS: Forty-five patients entered the study with a mean age of 30 years. Twenty percent of patients had nausea immediately postoperatively and 37% had nausea before discharge with no significant differences between groups. Overall rate of emesis, time in the recovery room, and time to discharge was not significantly different between the droperidol and ondansetron hydrochloride group. CONCLUSION: No real differences in the ability to prevent PONV between the two medications were found in this study.

Adolescent↗

PubMedDate not supplied

Augmented Hummelsheim procedure for paralytic strabismus.

PURPOSE: To report a modification of the Hummelsheim procedure for use in the management of paralytic strabismus. METHODS: Eight patients with paralytic strabismus secondary to third nerve palsy (n=1), sixth nerve palsy (n=3), combined cranial nerve palsy (n=1), or extraocular muscle damage (n=3) were treated using a modification of the Hummelsheim transposition procedure. The procedure involves half-tendon transpositions of the adjacent rectus muscles to the insertion of the paralyzed muscle, coupled with resection of the transposed halves. Further augmentation was achieved by surgical or pharmacologic weakening of the ipsilateral (n=6) or contralateral (n=1) antagonist. One patient underwent the procedure bilaterally. All patients underwent at least 6 weeks of follow-up. RESULTS: The mean preoperative primary position deviation in the seven unilateral cases was 54 prism diopters (delta) (range: 25-85 delta). Preoperative forced ductions were positive in four cases. Resections varied from 4-8 mm. Ipsilateral antagonist recession varied from 0-14 mm. The mean change was 52 delta (range: 25-85 delta). Five cases were aligned within 15 delta of orthotropia at 6 weeks. No cases of anterior segment ischemia or induced vertical deviation were noted. CONCLUSION: The modified Hummelsheim procedure appears capable of correcting large angles of strabismus associated with muscle palsy of various etiologies. It is safe, amenable to adjustable sutures, and relatively tissue- and vessel-sparing. Additional study is required to understand more fully the procedure's component effects and its interaction with ocular rotation.

Adolescent↗

PubMedDate not supplied

Effectiveness of mitomycin C in reducing reformation of adhesions following surgery for restrictive strabismus.

PURPOSE: To evaluate the efficacy of mitomycin C in reducing reformation of adhesions following surgery for restrictive strabismus. METHODS: Sixteen patients with restrictive strabismus resulting from trauma, retinal detachment surgery, and multiple squint surgeries were randomized to either a mitomycin group (8 patients) or a control group (8 patients). Mitomycin C (0.2 mg/mL) was applied intraoperatively for 5 minutes after release of adhesions. Range of passive ductions was scored for comparison. Postoperative follow-up ranged from 3-18 months. RESULTS: Compared to controls, the mitomycin C group had better range of passive ductions. There were no complications related to the cornea, intraocular pressure, uveitis, or muscle disinsertion in the mitomycin C group. CONCLUSION: Intraoperative application of mitomycin C (0.2 mg/mL for 5 minutes) is a safe and effective adjunct to surgery in the treatment of restrictive strabismus.

Adolescent↗

PubMedDate not supplied

Comparative evaluation of diclofenac and dexamethasone following strabismus surgery.

PURPOSE: To compare efficacy of topical diclofenac sodium 0.1% with dexamethasone 0.1% following strabismus surgery. METHODS: In this study, 58 patients undergoing strabismus surgery were evaluated. They were randomized into two groups: 29 patients received topical 0.1% diclofenac (Group A), and 29 patients received 0.1% dexamethasone (Group B) for 4 weeks. The baseline parameters were similar in both groups. At each visit comprehensive ocular examination was performed to record patient discomfort, conjunctival inflammation, gap, and intraocular pressure. Follow-up visits were at 1 week, 2 weeks, and 4 weeks, postoperatively. RESULTS: There was no statistically significant difference in the rate of resolution of the inflammation, conjunctival healing, and intraocular pressure except rise of intraocular pressure at the fourth postoperative week in group B (P value <0.001). CONCLUSIONS: The results of this study suggest that diclofenac may be used as an alternative to dexamethasone after strabismus surgery.

Administration, Topical↗

PubMedDate not supplied

Preliminary results of intraoperative daunorubicin in strabismus surgery.

PURPOSE: To evaluate the safety and efficacy of intraoperative daunorubicin (0.02%) for patients with strabismus undergoing a second surgical procedure. PATIENTS AND METHODS: Twenty-four patients with strabismus undergoing a second surgical procedure were randomly divided into two groups. In group A, daunorubicin 0.02% was applied subconjunctivally over the surface of the muscle and bare sclera for 3 minutes by cellulose sponge and then washed off thoroughly. In group B, distilled water was applied for 3 minutes in place of daunorubicin after the removal of adhesions. RESULTS: Satisfactory alignment in primary position with improved ocular motility was obtained in 80% of the patients in group A compared with 40% of the patients in group B after 12 months of follow-up (P = .16). CONCLUSION: We recommend intraoperative daunorubicin 0.02% for 3 minutes as an adjunct for better results in patients with strabismus undergoing a second surgical procedure.

Administration, Topical↗