64 patients treated in Pediatric Ophtalmology Department of National Institute of Ophtalmology in the year 1998, because functional strabisonus. The study conducted by descriptive intervention without control group in combining with a vertical study. Result showed that according to high instability, the oscillation reached 7-80, the proper method management will be choosen following clinical manifestation.
Therapeutics ; Surgery ; Strabismus

Strabismus surgeries using n-butyl-2-cyanoacrylate and 6-0 vicryl suture material were performed in 16 albino rabbits. Both eyes of 16 rabbits were used. The superior and inferior rectus muscles were recessed and resected 5 mm. In 12 rabbits, n-butyl-2-cyanoacrylate was used and those rabbits were divided into 3 groups, each group (4 rabbits, 8 eyes) was sacrificed 1, 2, and 3 weeks after operation respectively. The eyes were enucleated to examine the tensile strength and pathologic findings of the attached area. In 4 rabbits, 6-0 vicryl suture material was used as a control group in this study. This group was sacrificed and examined 3 weeks following the operation. In the cyanoacrylate groups, there were statistically significant differences and a chronologically increasing tendency of tensile strength between groups. Between the cyanoacrylate and the suture material group at 3 weeks post operation, there was no statistically significant differences in the tensile strength. Pathelogicallyr extraocular muscle bundles revealed patchy areas of interstitial inflammatory infiltration and fibrosis in the cyanoacrylate groups. Capillary telangiectasia and muscle fiber regeneration were commonly observed. The findings in specimens 3 weeks after operation revealed rather mild changes, suggesting healed lesions. In the suture material group, mild inflammatory reactions were found.
Animals ; Enbucrilate/*therapeutic use ; Rabbits ; Strabismus/pathology/*surgery ; Tensile Strength

A large recession of one lateral rectus muscle for exotropia is an infrequently used procedure. In this prospective study, 27 patients (3 to 19 years, mean age of 7) with moderate-angle exodeviation (18-35delta) were treated with large recession (8mm-9mm) of one lateral rectus muscle on their non preferred eye. Initially, there was underaction of the lateral rectus muscle. Within 6 weeks, the lateral rectus muscle regained full abduction, incomitance resolved, and the deviation was eliminated or reduced to a small phoria. Since surgery is confined to the deviating eye alone, operating time, length of anesthesia, and postoperative discomfort is reduced. The average amount of prism diopters needed for correction following operation for 8mm, 8.5mm and 9mm were 20.4delta, 26.4delta, and 31.3delta respectively and esthetically satisfactory results (within 10delta exodeviatior) were obtained in 90.I% of the patients.
Adolescent ; Adult ; Child ; Child, Preschool ; Exotropia/*surgery ; Humans ; Oculomotor Muscles/*surgery ; Prospective Studies ; Strabismus/*surgery

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia.
Exotropia/*complications/*surgery ; Humans ; Male ; Middle Aged ; Oculomotor Muscles/*surgery ; Strabismus/*complications/*surgery ; Treatment Outcome

In this study, we explored the neural mechanism underlying impaired stereopsis and possible functional plasticity after strabismus surgery. We enrolled 18 stereo-deficient patients with intermittent exotropia before and after surgery, along with 18 healthy controls. Functional magnetic resonance imaging data were collected when participants viewed three-dimensional stimuli. Compared with controls, preoperative patients showed hypoactivation in higher-level dorsal (visual and parietal) areas and ventral visual areas. Pre- and postoperative activation did not significantly differ in patients overall; patients with improved stereopsis showed stronger postoperative activation than preoperative activation in the right V3A and left intraparietal sulcus. Worse stereopsis and fusional control were correlated with preoperative hypoactivation, suggesting that cortical deficits along the two streams might reflect impaired stereopsis in intermittent exotropia. The correlation between improved stereopsis and activation in the right V3A after surgery indicates that functional plasticity may underlie the improvement of stereopsis. Thus, additional postoperative strategies are needed to promote functional plasticity and enhance the recovery of stereopsis.
Humans ; Exotropia/surgery* ; Depth Perception/physiology* ; Strabismus/surgery* ; Oculomotor Muscles/surgery*

Successfully predicting an oculocardiac reflex (OCR) is difficult to achieve despite various proposed maneuvers. The aim of this study was to test the models built up by neural networks to predict the occurrence of OCR during strabismus surgery in children. Premedication was not given. Atropine 0.01 mg/kg was medicated just before induction. Induction was performed with fentanyl or ketorolac, followed by propofol. Atracurium or vecuronium was given for intubation. Anesthesia was maintained with O2-N2O with continuous propofol infusion. Chi-square test was performed for induction agents, gender, weight, muscle blockade, repaired muscle, number of repaired muscles, duration of operation to detect any association between the occurrence of OCR and to develop the model of neural networks. The multi-layer perceptron, radial basis function and Bayesian backpropagation network were tested. The occurrence of OCR was significantly associated with gender and repaired muscle (p < 0.05). Gender, repaired muscle and age were considered as input for the multi-layer perceptron, radial basis function and Bayesian backpropagation network. Three neural networks had predicted the same correction rate in the occurrence of OCR as being 87.5% overall among 16 patients' records tested. These models are conceptually different in predicting compared to conventional maneuvers, and have the advantage of testing individually and foretelling the propensity. By comparison neural networks use grouped experiential data and predict OCR by the learning rule. Neural networks require a relatively abundant number of experienced and homogenous patients' records to establish an accurate model. The multi-layer perceptron, radial basis function and Bayesian backpropagation modeling network may be an alternative way, and preferable to vagal tone maneuvers if the associated relationships to the occurrence of OCR are more clearly defined.
Adolescence ; Child ; Child, Preschool ; Forecasting ; Human ; Infant ; Intraoperative Period ; Neural Networks (Computer)* ; Reflex, Oculocardiac/physiology* ; Strabismus/surgery* ; Strabismus/physiopathology*

OBJECTIVETo evaluate the rule of the rebuilding of binocular vision after surgery in strabismus for thyroid-associated ophthalmopathy.

METHODThe binocular vision was examined and compared in 30 patients before and after strabismus surgeries.

RESULTSThe strabismus degrees were 20-80(delta) before surgeries and 2-12(delta) after surgeries. As shown by synoptophores examinations, 19 patients (63.3%) had degree one before strabismus surgeries and the number increased to 28 (93.3%) after the surgeries. Synoptophore fusion area was 0-12(0) [mean (6.1 +/- 4.7)0] before strabismus surgeries and was 0-30(0) [mean (14.4 +/- 5.1)0] after the surgeries (P < 0.001). Nine patients (30%) had stereovision before strabismus surgeries, and the number increased to 22 (73.3%) after the surgeries. Pre-surgery stereoacuity was as follows: none < or = 60", 2 patients 80-200", and 4 patients 300-800"; while the post-surgery stereoacuity was as follows: 4 patients < or = 60", 6 patients 80-200", and 10 patients 300-800" (P < 0.05).

CONCLUSIONStrabismus surgeries for thyroid-associated ophthalmopathy can effectively improve ocular movement and rebuilt binocular vision.

This report presents the use of various surgical treatment modalities in patients who were diagnosed as having thyroid ophthalmopathy. The records of 53 patients who received surgery because of thyroid ophthalmopathy at the Department of Ophthalmology, Yonsei University College of Medicine between Sept. 1996 and Jan. 2000 were retrospectively evaluated. Among the 53 patients, there were 30 females and 23 males. The mean ages of the patients were 40.8 +/- 17.1 years. Orbital wall decompression (52.8%) was the most frequently performed surgery followed by lid surgery (49.1%) and strabismus surgery (26.4%). Only one type of surgery was performed on 86.8% of the patients while 13.2% received more than one type of surgery. Among the many different types of surgeries possible in patients that have thyroid ophthalmopathy, orbital wall decompression, lid surgery, and strabismus surgery are the most commonly used surgical methods for treatment.
Adult ; Decompression, Surgical ; Eyelids/surgery ; Female ; Graves' Disease/*surgery ; Human ; Male ; Middle Age ; *Ophthalmologic Surgical Procedures ; Orbit/surgery ; Strabismus/surgery

Strabismus fixus is very rare and the convergent form is rarely accompanied by blepharoptosis. We successfully treated one patient with high myopia whose convergent strabismus fixus, accompanied by blepharoptosis, became severe after cataract surgery. We report the case with a discussion of its pathology. We performed levator advancement operation, bilateral lateral rectus 11 mm resection, and bilateral medial rectus 8 mm recession. The suture was removed after maintaining temporary traction suture for 6 days. Blepharoptosis was completely corrected by postoperative 2 months. Esodeviation was 15PD, which was not increased compared with immediately after surgery. Satisfactory cosmetic outcome was obtained.
Aged ; Blepharoptosis/complications/*surgery ; Female ; Humans ; Myopia/complications ; Oculomotor Muscles/*surgery ; Ophthalmologic Surgical Procedures/methods ; Strabismus/complications/*surgery ; Treatment Outcome

PURPOSE: To investigate the symptoms of attention deficit hyperactivity disorder (ADHD) as reported by parents in children with intermittent exotropia [X(T)] and to determine whether strabismus surgery for X(T) affects ADHD symptoms. MATERIALS AND METHODS: Fifty-one consecutive children undergoing muscle surgery for X(T) were prospectively recruited. One parent of each child completed the ADHD rating scale IV (ADHD RS-IV) assessment consecutively before and one year after surgery. Patients whose preoperative scores were above the cut-off point, the 90th percentile based on a Korean sample, were regarded as demonstrating the ADHD trait. The impact of muscle surgery on ADHD symptoms was assessed by comparing the preoperative scores with the post-operative scores. RESULTS: Eight (15.7%) of the 51 patients demonstrated the ADHD trait. ADHD RS-IV scores following strabismus surgery significantly decreased in patients with the ADHD trait (p=0.014), while they did not differ in patients without the ADHD trait. Seven (87.5%) of the 8 patients with the ADHD trait showed improvement in their ADHD RS-IV scores after surgery. There was no difference in surgical success rates between X(T) patients with and without the ADHD trait. CONCLUSION: The ADHD trait was relatively common in children with X(T), and the parent-reported symptoms of the children with the ADHD trait improved after strabismus surgery. These results suggest that childhood X(T) may be one contributing factor to ADHD-related symptoms.
Attention Deficit Disorder with Hyperactivity/*diagnosis ; Child ; Child, Preschool ; Exotropia/*physiopathology ; Female ; Humans ; Male ; *Parents ; Strabismus/*surgery