No abstract available.
Strabismus*

No abstract available.
Strabismus*

Anterior transposition of inferior oblique muscle(ATIO) is known to an effective procedure for correcting marked overaction of inferior oblique muscle. However, depression in abduction and elevation deficiency in primary and abduction positions have occurred without adherence syndrome after this procedure. To avoid these complications, the author modiffied ATIO by transposing only the anterior portion of inferior oblique muscle at 2mm anterior to the temporal insertion site of inferior rectus, and placing the posterior portion of muscle just posterior to the insertion site of inferior rectus. Modified ATIO was performed in 4 cases of inferior oblique overaction(IOOA) with dissociated vertical deviation(DVD), 2 cases of unilateral IOOA withcontralateral superior oblique overaction(SOOA) and 5 cases of superior oblique palsy(SOP) Knapp class IV. They were observed for over 6 months (6~18 months). Three of 4 cases of IOOA with DVD were improved but adherence syndrome occurred in one case and depression in abduction occurred in another case. In 2 cases of unilateral IOOA with contralateral SOOA, hypertropia was decreased from 20delta and 2delta respectively, after the procedure. In 5 cases of SOP Knapp class IV, preoperative hypertropia was 20delta-40delta in primary position. After modified ATIO, hypertropia was 0delta-20delta . The correction effect was 12delta-35delta , with an average of 18.4delta in primary position. In 4 of 5 cases, hypertropia was corrected within 10delta in primary position. Modified ATIO is an effective procedure for unilateral IOOA with contralateral SOOA and SOP Knapp class IV as a single muscle surgery.
Depression ; Strabismus

Numerous authors published tables showing the amount of strabismus surgery and the effectivity. Although Scobee and Knapp etc. stressed the difficulty of making an accurate prediction of strabismus surgery. the standardized formula of the surgical treatment of strabismus has long been the ambition of ophthalmologist. Author agreed with the opinion of Dyer who provided the ophthalmologist with excellent tables suggesting combinations of muscles and amount of surgery to correct various types of strabismus and so 132 cases of comitant horizontal strabismus treated surgically with Dyer method at Kong Eye Clinic from August 1975 to July 1976 were analyzed. With author's data. this paper present a mathematical formula to estimate the amount of strabismus surgery.
Muscles ; Strabismus*

A study on 96 children with squint of which cross-eyed (74) treated in the institute of ophthalmology during 1993-1996 has shown that the merely exercise treatment recovered the biocular vision well for squint, for the latent squint at high grade, alternant squint at high grade, local accommodative cross eyed and concomitant squint at high grade, it should combine the exercise and balance surgical treatment.
Strabismus ; child

Plication of horizontal recti with many advantages in the treatment of strabismus has been applied by many authors in the world, but not yet in Vietnam. Objectives: to evaluate the results of this surgery that applied in Vietnamese. Methods: Prescriptive, longitudinal prospective study that had been done in Hanoi National Institute of Ophthalmology from 9/2003 to 9/2004. Results: In postoperative period, 83.3% of cases with exotropia and 89.6% of cases with esotropia are well corrected after 6 months, 100% of operated eyes are well healed with a smooth conjunctive scars and 52.62 % of operated patients have got a full binocular vision after 3 months following up. The rate of the eyes with suspected amblyopia is reduced from 18.8% to 9.8%, with moderate amblyopia is also reduced from 8.8% to 2.4% by 6 months postoperatively, but the rate of the eyes with severe amblyopia is not significantly changed after surgery. Conclusion: Plication of horizontal recti is a safe, effective method for correction of strabismus, especially when it is necessary to do surgery on many extra-ocular muscles in the same eye.
Strabismus ; Therapeutics

PURPOSE: We assessed the relationship between the surgical outcome of intermittent exotropia and initial postoperative alignment by checking it on the first postoperative day or the day of strabismus surgery. METHODS: Seventy-three patients with intermittent exotropia underwent bilateral lateral rectus recession or unilateral medial rectus resection and lateral rectus recession. Thirty-two patients had their postoperative alignment checked on the day of surgery, and forty-one patients were checked on the first postoperative day. Success was defined as sustained alignment six months postoperatively from esotropia 10PD to exotropia 10PD. Overcorrection was defined as esotropia greater than 11PD, and undercorrection was exotropia greater than 11PD. We assessed the relationship between the alignment on the day of surgery or on the first postoperative day and also at six months postoperatively, as well as the success rate according to the initial postoperative alignment. RESULTS: There was a statistically significant relationship between alignments on the day of surgery or on the first postoperative day and those at six months postoperatively (p<0.001, p<0.001). The deviation on the first postoperative day had a greater correlation coefficient compared to the deviation on the day of the operation (Pearson correlation coefficient=0.704, and 0.593, respectively). The alignment of overcorrection ranged from 11~20PD on the day of surgery, and on the first postoperative day it produced a relatively high success rate (p=0.016, p=0.035). There was no statistically significant difference in the success rate between the two types of surgery (p=0.832). CONCLUSIONS: The alignment on the day of surgery showed a high correlation to the outcome on the sixth postoperative month in intermittent exotropia patients. The initial postoperative overcorrection of 11 to 20PD on the day of surgery and on the first postoperative day resulted in the best long-term outcomes.
Esotropia ; Exotropia* ; Humans ; Strabismus

In twenty five patients with vertical strabismus including dissociated vertical deviation, the auther measured the width of the superior rectus muscle insertion and the distances from posterior limbus to nasal, middle and temporal portion of the superior rectus insertion. The means of width of the insertion was 9.8mm +/- 0.92, the distances from the posterior limbus to the nasal, middle and temporal portion of the superior rectus insertion were 7.2mm +/- 0.92, 6.9mm +/- 0.7, and lO.8mm +/- 1.0 (in 7 cases) respectively. Statistically, the means of these measurements of DVD were not significantly different from other vertical strabismus patients. These reults suggest that the etiology of the DVD is not anatomic but neurogenic in origin.
Humans ; Muscles* ; Strabismus*

Recently hang-back recession is chosen instead of conventional recession to get better result in strabismus surgery. Jampolsky method, a popular method of hang-back recession, has some draw-backs; the extraocular muscle width can be decreased, the center of the muscle can be sagging posteriorly, and the amount of recession can be somewhat shortened than expected in operation. Accordingly, we devised a new modified hang-back recession and compared with Jampolsky method. Two months after respective operation in 7 albino rabbits, the width of the muscle comparing to preoperative condition, the amount of recession, and the sagging of middle part of the muscle were evalvated in comparison with the preoperative findings. The width of muscles was significantly shortened in Jampolsky method in comparison with preoperative condition (p<0.05), but not in our new method (p>0.05). The amount of recession by Jampolsky method was significantly shortened than expected in operation (p<0.05), but not by our new method (p>0.10). The significant sagging of the muscle was found with Jampolsky method (p<0.05), but not with our modified method (p>O.lO). In review of these findings, our new method is devoid of some draw backs of Jampolsky method.
Muscles ; Rabbits ; Strabismus

PURPOSE: To evaluate the effect of amniotic membrane and additional use of 2% methylcellulose(Methocel(R)) in reducing the postoperative adhesions following strabismus surgery. METHODS: Twenty white rabbits (40 eyes) were divided into 4 groups: control group C (12 eyes), trial group A (12 eyes), trial group B (12 eyes), and normal group N (4 eyes). In group C, the superior rectus was detached and scleral scratching was done to provoke a fibrotic reaction, and then, the superior rectus was reattached to the original insertion site. In group A, the above procedure was done and in addition, the superior rectus was covered with two-folded amniotic membrane. In group B, the same procedure was done as in group A and in addition, Methocel(R) was coated between the muscle and adjacent tissues. Eight weeks later, we divided each group into two subgroups. In one group, we examined the degree of adhesion by the blunt dissection between the muscle and adjacent tissues, and in the other group, the histologic findings with a light microscope between the muscle and adjacent tissues. RESULTS: The adhesion degree on the blunt dissection and histologic examination was significantly reduced in groups A and B. But no statistically significant difference between groups A and B was shown in the postoperative adhesion. CONCLUSIONS: From these findings, it is expected that the use of amniotic membrane may reduce the postoperative adhesion after strabismus surgery and theadditional use of Methocel(R) may not be useful.
Amnion* ; Methylcellulose* ; Rabbits ; Strabismus*