For the 6th nerve paralysis, we use the procedure described by Jensen combined with a 6-7mm recession of the madial rectus muscle. But, anterior segment ischemia(ASI) is an occasional complication of this surgery in which over three rectus muscles are partially or completely detached, ligated. The authors performed this modified Jensen procedure to the patient of 6th nerve paralysis, in which anterior ciliary arteries of vertical rectus muscles were separated from the muscles under the operating microscope and then ligated muscles only. So, this modified procedure preserve the integrity of the anterior ciliary arteries in those portions of the vertical muscles not involved in the muscle union to avoid the danger of anterior segment ischemia.
Ciliary Arteries* ; Humans ; Ischemia ; Muscles ; Paralysis

It was reported that muscle-scleral tuck with nonabsorbable suture material helps to preserve anterior ciliary artery circulation and to prevEnt anterior segment ischemia. The authors measured maximum adhesion power and obsesved histopathologic findings at 1st, 2nd, 4th, and 8th week following a muscle-scleral tuck procedure with absorbable suture material in rabbits. Maximum adhesion powers were increasing with time, 110, 120, 150, and 250gm at each week respectively, and kept enough tension for using absorbable suture material Histopathologic findings demonstrated that inflammatory and foreign body reactions decreased with time, and collagen fibers were proliferated at muscle scleral contact area, and fibers in muscle and sclera connected each other and formed firm adhesion. We concluded that muscle-scleral tuck with absorbable suture material maintained adhesion power enough as a rectus muscle strengthening procedure.
Ciliary Arteries ; Collagen ; Foreign Bodies ; Ischemia ; Muscles* ; Rabbits* ; Sclera ; Sutures*

This study was performed to evaluate the effect of hematoma which often occurred during the strabismus surgery on the extraocular muscles. We created focal hematomas around the superior rectus mascles of three dogs by rupture of the anterior ciliary artery. One, two and four weeks after formation of the hematoma respectively, we resected the superior rectus muscles 7mm in length at the site of previous hematoma and histopathologic examination with a light microscope was performed. We could not find any specific pathologic change in the muscular fiber in one week after surgery. But, focal degeneration of the muscle fiber was found in that of two weeks and diffuse degeneration in that of four weeks after surgery. However, any fibrotic lesion was not found. The muscle degeneration may be caused by the pressure of hematoma and ischemia due to small arterial occlusion.
Animals ; Ciliary Arteries ; Dogs ; Hematoma* ; Ischemia ; Muscles ; Rupture ; Strabismus

Using ocularluminal methylmethacrylate corrosion casting, we obsesved three-dimentional anterior uveal microcirculation of the rabbit eyes with scanning electron microscope. The two terminal branches of each long posterior ciliary artery turn opposite direction within the iris to run concentric to the pupil; the superior and inferior branches forming the major iridic circle (MIC). Radial branches run both proximally and distally from the MIC, the former distributing to the ciliary process, choroid and ciliary body and the latter distributing to the iris. Venous drainage of the anterior uvea is taken care of by the large iridociliary veins and by marginal capillaries of the process. Each of these drains to the large vessel layer of the choroid and subsquently to the vortex vein.
Capillaries ; Choroid ; Ciliary Arteries ; Ciliary Body ; Corrosion Casting ; Drainage ; Iris ; Methylmethacrylate ; Microcirculation ; Microscopy, Electron, Scanning* ; Pupil ; Uvea ; Veins

Using ocularluminal methylmethacrylate corrosion casting, we obsesved three-dimentional anterior uveal microcirculation of the rabbit eyes with scanning electron microscope. The two terminal branches of each long posterior ciliary artery turn opposite direction within the iris to run concentric to the pupil; the superior and inferior branches forming the major iridic circle (MIC). Radial branches run both proximally and distally from the MIC, the former distributing to the ciliary process, choroid and ciliary body and the latter distributing to the iris. Venous drainage of the anterior uvea is taken care of by the large iridociliary veins and by marginal capillaries of the process. Each of these drains to the large vessel layer of the choroid and subsquently to the vortex vein.
Capillaries ; Choroid ; Ciliary Arteries ; Ciliary Body ; Corrosion Casting ; Drainage ; Iris ; Methylmethacrylate ; Microcirculation ; Microscopy, Electron, Scanning* ; Pupil ; Uvea ; Veins

The clinical picture of central retinal artery occlusion is well known. Little is known, however, about the clinical picture of occlusion of the posterior cilliary arteries. The effects of such condition have been investigated by Hayre(1972) with the experimental occlusion of the various posterior ciliary arteries individually or together in rhesus monkey. The authors have experienced a case of 21 years old woman with the visual field defects developed by the human posterior ciliary arterial occlusion via a pathologic embolic process. A bridf review of the related literatures is presented.
Arteries ; Ciliary Arteries ; Female ; Humans ; Macaca mulatta ; Retinal Artery Occlusion ; Visual Fields ; Young Adult

To evaluate the usefulness of indocyanine green (ICG) iris angiography in darkly pigmented iris and to investigate whether the anterior segment ischemia can be produced by tenotomies of two or more rectus muscles in rabbits, twenty one eyes of 21 pigmented rabbits wer divided into four groups according to the surgical procedures. Group I (2 eyes) underwent only conjunctival peritomy as a control. Group II (6 eyes), Group III (9 eyes), Group IV (4 eyes) underwent tenotomies of two, three and four rectus muscles, respectively. All these eyes underwent ICG iris angiography at pre-op, post-op 10 housrs, 3 days, 7 days and 14 days. In eight eyes of Group I and Group II, fluorescein iris angiography was taken simultaneously. The quality of fluorescein iris angiography was much lower in the pigmented iris and the interpretation was more difficult compared to ICG iris angiography. The peritomy (Group I) or tenotomies of two rectus muscles (Group II) produced no circulatory defect of the iris even after 10 hours postoperatively. After tenotomies of three rectus muscles (Group III) there were transient mild filling defects in superior or inferior sector of iris in 7 of 9 eyes. These defects lasted for 1 to 3 days. Tenotomies of four rectus muscles (Group IV) produced transient filling defects which lasted for 1 to 7 days. ICG iris angiography was suitable for the evaluation of anterior segment circulation in darkly pigmented iris, thus, it can be applied to the coriental brown iris. And in contrast to the previous concept that the rabbits iris arteries derive solely from the long posterior ciliary arteries, circulatory disturbance of iris, even though transient, could be produced by severance of rectus muscles.
Angiography* ; Arteries ; Ciliary Arteries ; Fluorescein ; Indocyanine Green* ; Iris* ; Ischemia* ; Muscles ; Rabbits* ; Tenotomy

Anterior segment ischemia(ASI) may be caused by a detachment of the rectus muscles from the globe. The interruption of the anterior ciliary artery by the detachment of rectus muscles causes a subsequent hypoperfusion to the anterior segment. ASI occurs more easily after surgery on the vertical rectus or after detachments of two or more adjacent rectus muscles. We experienced two patients with ASI after performing muscle surgery on them for lateral rectus muscle palsy caused by a traffic accident. A 5-year-old-male developed keratitis and uveitis following a Hummelsheim operation in combination with a lateral rectus resection in his right eye. A 51-year-old female showed keratitis, uveitis and pupilary distortion after a Knapp procedure combined with a lateral rectus tucking in her right eye. Both patients recovered without any complications.
Accidents, Traffic ; Ciliary Arteries ; Female ; Humans ; Ischemia* ; Keratitis ; Middle Aged ; Muscles ; Paralysis ; Strabismus* ; Uveitis

We have performed recession of all 4 rectus muscle in 8 eyes with neovascular or absolute glaucoma. The visual acuity of these eyes ranged fram no light perception to recognition of hand motion. As the purpose of surgery was to destroy all anterior ciliary arteries from the rectus muscles, after performing 2mm recessions on all 4 rectus muscles we applied cryotherapy on the oclera from he original rite to the mear insertion site. The cases were followed up for periods ranging from 3 to 19 months, with an average of 10.3 months. At the end of follow-up periods, we observed a statistically significant drop (p<0.05) in the intraocular pressure level, from the preoperative leveI of 49.8 +/- 7.9 mmHg (mean +/-SD) to 36.6 +/- 18.1 mmHg without any additional medical therapy. However, the decreases were not notable. In the treatment of neovascular glaucoma for absolute glaucoma, we have found that simultaneous disruption of all anterior ciliary arteries through anterior segment ischemia will not result in a satisfactory decrease in postoperative intraocular pressure.
Ciliary Arteries ; Cryotherapy ; Follow-Up Studies ; Glaucoma* ; Glaucoma, Neovascular* ; Hand ; Intraocular Pressure ; Ischemia ; Muscles* ; Visual Acuity

Ophthalmic artery occlusion results in a circulatory disturbance of both central retinal artery and posterior ciliary arteries, causing an ischemia of retina and choroid. On fundus examination, white retinal opacification and cherry-red spot can be noted if central retinal artery occlusion is not associated with lateral posterior ciliary artery obstruction. If, however, central retinal artery occlusion is asssociated with lateral posterior ciliary artery obstruction, the cherry-red spot is no longer visible. The author experienced five patients with a mottled loss of retinal transparency in the macular region. Combined central retinal artery occlusion with obstruction of both medial posterior ciliary artery and lateral posterior ciliary artery were observed in two patients, both central retinal artery occlusion and medial posterior ciliary obstruction in two patients, and central retinal artery occlusion alone in one patient. The fundus findings in all five cases are compatible with an incomplete central retinal artery occlusion which in at least four cases was associated with evidence of choroidal vascular obstruction.
Choroid ; Ciliary Arteries ; Humans ; Ischemia ; Ophthalmic Artery ; Retina ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde