1/72. Clinical features and surgery for acquired progressive esotropia associated with severe myopia.PURPOSE: The purpose of this study was to evaluate the clinical and physiological findings and to determine the most appropriate surgical procedure for acquired progressive esotropia with severe myopia. methods: Thirty-eight cases of acquired progressive esotropia with severe myopia were examined to evaluate their clinical and physiological findings. All cases were divided into four groups according to the limitation of their abduction. The eyeball in group IV is fixed in an extremely adducting position. Thirty-one cases underwent strabismus surgery; medial rectus muscle recession and lateral rectus muscle resection in 23 cases, transposition of superior and inferior rectus muscles (modified Jensen procedure included) in eight cases. RESULTS: The medial rectus muscle recession with the lateral rectus muscle resection procedure was effective in the early stage of acquired progressive esotropia patients. Transposition procedure was effective in the severe abducting limited patients. CONCLUSIONS: As the recession & resection procedure is easier than the transposition procedure, we recommend performing surgery in the earlier stage of the abducting disorder before the eyeball is fixed in an extremely adducting position.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/72. strabismus surgery in children with mobius syndrome.mobius syndrome is a congenital disorder of facial diplegia associated with lateral gaze paralysis. Although palsy of the sixth and seventh cranial nerves is the minimum diagnostic finding for mobius syndrome, neuropathologic evidence indicates that this is a more complex syndrome.(1) Clinically, it is characterized by a total absence of facial expression and severe esotropia. Other anomalies may be associated with this syndrome, especially other cranial nerve palsies and poland syndrome. The etiology of this syndrome has not been clearly established. brain stem necrosis resulting from a vascular deficiency has been offered as a possible pathogenetic explanation.(2) The strabismus in mobius syndrome is congenital esotropia with bilateral limitation in abduction. Even though many reports have described the various features of mobius syndrome, only a few articles have reported the results of strabismus surgery in children, including bimedial rectus muscle recession. (3-5) Some authors report that bilateral medial rectus muscle recession alone has been disappointing; therefore, a combination of a medial rectus muscle recession and a lateral rectus muscle resection was recommended for satisfactory results. (5-7) In more severe cases, muscle transposition was needed to ensure straight position of the eyes in primary gaze. (8-9)- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
3/72. Duane's syndrome with compressive denervation of the lateral rectus muscle.PURPOSE: To describe an unusual case of Duane's syndrome. methods: Individual case report. RESULTS: A skull base meningioma was discovered in a woman with Duane's syndrome who presented with recurrent, large-angle esotropia and uncharacteristic atrophy of the lateral rectus muscle on magnetic resonance image (MRI) scan. CONCLUSION: neuroimaging may be useful in unusual cases of Duane's syndrome.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
4/72. Spontaneous resolution of infantile esotropia.PURPOSE: To report the spontaneous resolution of infantile esotropia in 3 patients. methods: The clinical histories and the results of ophthalmologic examinations in 3 patients with infantile esotropia were reviewed and analyzed with reference to the literature. RESULTS: All 3 patients with infantile esotropia were diagnosed with 25 to 30 PD of esotropia before the age of 6 months. All of them had insignificant refractive errors. Against medical advice, they were not brought in for follow-up examinations. At the age of 34 months to 59 months, the esotropia of the patients had changed into exophoria, esophoria less than 4 PD, or orthophoria. All patients eventually showed dissociated vertical deviation and overaction of the inferior oblique muscles. Of the 2 cooperative patients, 1 consistently identified Titmus stereograms with 3000 seconds of arc and fused Worth 4 dots at near and at distance. The other patient could not identify stereo targets and suppressed one eye on Worth 4 testing at distance, though she showed no suppression at near. CONCLUSION: In these cases, infantile esotropia with a relatively small angle may spontaneously resolve without any treatment. However, all these patients showed poor stereoacuity, dissociated vertical deviation, and overaction of the inferior oblique muscles.- - - - - - - - - - ranking = 0.4keywords = muscle (Clic here for more details about this article) |
5/72. Delayed orbital hemorrhage after routine strabismus surgery.PURPOSE: To report a case of delayed rectus muscle hemorrhage after strabismus surgery. methods: Case report. RESULTS: Rectus muscle hemorrhage occurred 36 hours after strabismus surgery in a 26-year-old man, causing temporary loss of vision and reduced ocular motility. Urgent lateral cantholysis and orbital exploration to restore hemostasis were undertaken. Full recovery of vision occurred and a small residual motility disturbance was present 3 months postoperatively. CONCLUSION: Delayed rectus muscle hemorrhage poststrabismus surgery is rare but can have sight-threatening effects. When vision is threatened because of optic nerve compromise, urgent orbital exploration may allow full recovery of function.- - - - - - - - - - ranking = 0.6keywords = muscle (Clic here for more details about this article) |
6/72. Treatment of A-pattern esotropia with marked mongoloid slanting palpebral fissures.BACKGROUND: The association of oblique palpebral fissures and A- or V-pattern has not been clarified. We report two cases of A-pattern esotropia with marked mongoloid slanting palpebral fissures associated with vertical displacement of the horizontal rectus muscle. CASES: Case 1 was a boy with prader-willi syndrome. He showed A-pattern esotropia with upward slanting palpebral fissures. Severe superior oblique muscle overaction was observed. Case 2 was a girl with meningocele. She also showed A-pattern esotropia with upward slanting palpebral fissures. OBSERVATIONS: In case 1, weakening surgery of the superior oblique muscles did not improve the A-pattern. Coronal images of computed tomography showed one-half-muscle-width upward displacement of both lateral rectus muscles. After downward transposition surgery of the lateral rectus muscles, the preoperative A-pattern of 25 prism diopters (PD) was successfully corrected to 10 PD. In case 2 also, upward displacement of both lateral rectus muscles was shown by computed tomography. The preoperative A-pattern of 26 PD was corrected to 4 PD postoperatively after upward transposition surgery of the medial rectus muscles. CONCLUSIONS: The vertical displacement of horizontal rectus muscles was considered the principal cause of A-pattern in these cases associated with marked mongoloid slanting palpebral fissures.- - - - - - - - - - ranking = 1.8keywords = muscle (Clic here for more details about this article) |
7/72. Anterior segment ischemia after surgery on 2 vertical rectus muscles augmented with lateral fixation sutures.Anterior segment ischemia is a rare but potentially serious complication of strabismus surgery. Anterior ischemia typically occurs after surgery on 3 or 4 rectus muscles. Advanced age, dysthyroid ophthalmopathy, and a history of previous strabismus surgery are known risk factors for this complication. This report reviews the case of a healthy 50-year-old patient who developed anterior segment ischemia after surgery on 2 rectus muscles.- - - - - - - - - - ranking = 1.2keywords = muscle (Clic here for more details about this article) |
8/72. Acute comitant esotropia after cataract surgery.A 52-year-old woman developed comitant esotropia after cataract surgery. The ocular history was significant for accommodative esotropia; preoperatively, she manifested peripheral fusion with central suppression. Immediately postoperatively, the patient was diplopic with comitant esotropia and was treated with extraocular muscle surgery. The appearance of horizontal strabismus after cataract surgery in patients with a history of accommodative esotropia, especially those with subnormal binocularity, is a possible complication that should be discussed with the patient.- - - - - - - - - - ranking = 0.2keywords = muscle (Clic here for more details about this article) |
9/72. Myopic strabismus fixus: a mitochondrial myopathy?PURPOSE: Ultrastructural analysis of extraocular muscle in a case of myopic strabismus fixus. DESIGN: Interventional case report. methods: Incisional biopsy and ultrastuctural analysis of recti muscles in a female patient with myopic strabismus fixus. RESULTS: Ultrastuctural analysis revealed evidence of mitochondrial myopathy. CONCLUSION: Acquired strabismus fixus due to high myopia may be a manifestation of mitochondrial myopathy, a finding that has not been previously reported.- - - - - - - - - - ranking = 0.4keywords = muscle (Clic here for more details about this article) |
10/72. Autosomal recessive blepharophimosis, ptosis, V-esotropia, syndactyly and short stature.A recessively inherited syndrome of blepharophimosis and ptosis with weakness of extraocular and frontal muscles is reported in six members of three related kindreds. prognathism, synophrys and thick eyebrows added to a typical facial appearance. Additional findings included short stature, borderline head circumference and toe syndactyly. Borderline mental retardation and anosmia were found in one patient. The clinical features and the mode of inheritance distinguish this syndrome from other blepharophimosis and ptosis syndromes.- - - - - - - - - - ranking = 0.2keywords = muscle (Clic here for more details about this article) |
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