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

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

Most patients with strabismus are in good health. However, the incidence of strabismus is high in patients with central nervous system dysfunction and musculoskeletal abnormalities. Authors report one case of intracerebral hematoma due to bleeding from an intracranial arteriovenous malformation after a surgical correction of strabismus under general endotracheal anesthesia. The initial operation and postoperative course of this case were uneventful except for several episodes of nausea and vomiting, continuing hours after the operation. Twenty-four hours after the operation, the patient showed a stuporous mental state and right-sided hemiplegia. A brain C-T scan and carotid angiography revealed an intracerebral hematoma with small-sized vascular abnormalities in the frontoparietal region on the left side. Following an emergency evacuation of the hematoma and removal of the malformed vessels, the patient showed progressive improvement.
Cerebral Hemorrhage/etiology* ; Child ; Female ; Hematoma/etiology* ; Human ; Intracranial Arteriovenous Malformations/complications ; Postoperative Complications* ; Rupture, Spontaneous ; Strabismus/surgery*

Inferior oblique myectomies or Z-myotomies were performed on 159 eyes of 121 patients who had an overacting inferior oblique muscle or muscles. The results were as follows; 1. Success rates were 95.5% in myectomy and 71.4% in Z-myotorny. 2. Recurrence rates were 2.7% in myectomy and 14.3% in Z-myotomy. 3. There were no other complications to include the adherence syndrome.
Adolescent ; Age Factors ; Child ; Child, Preschool ; Eye Diseases/*surgery ; Follow-Up Studies ; Humans ; Infant ; Oculomotor Muscles/*surgery ; Strabismus/complications

OBJECTIVE: To evaluate the oblique angle, diplopia and stereoacuity before and after rectus recession-suspension on posterior sclera surgery in patients with restrictive strabismus caused by thyroid associated ophthalmopathy (TAO). METHODS: Data from 18 patients (19 eyes) with restrictive strabismus caused by TAO, who underwent rectus recession-suspension on posterior sclera surgery from July 2010 to June 2013 in Xiangya Hospital, Central South University, were analyzed retrospectively. Eight patients (8 eyes) or 5 patients (5 eyes) with hypotropia were operated with inferior rectus recession or superior rectus recession. Two patients (2 eyes) with esohypertropia or 3 patients (4 eyes) with esotropia were operated with inferior rectus recession plus medial rectus recession or medial rectus recession. Two patients (1 hypotropia, 1 esotropia) underwent orbital decompression surgery before strabismus surgery. All patients were performed rectus recession-suspension on posterior sclera surgery, and the oblique angle, diplopia view and stereopsis test were examined before and after the operation. RESULTS: All patients were followed up for more than 6 months. The preoperative prism were 20(Δ)- 80(Δ) and postoperative prism were 2(Δ)-10(Δ). There was diplopia on the primary position before surgery in 16 patients. After surgery, the diplopia in 14 patients disappeared on the primary and 15° down gaze, and 2 patients had not diplopia on the primary position but residual diplopia on inferior field. Two patients had stereopsis before surgery, and the numbers of patients raised to 14 after surgery. Compared with pre-operation, changes of the above measured indexs in post-operation were significant difference (all P<0.05). CONCLUSION The rectus recession-suspension on posterior sclera surgery is effective to improve oblique angle and diplopia in restrictive strabismus caused by TAO, which can improve patient's living quality.
Decompression, Surgical ; Diplopia ; Graves Ophthalmopathy ; complications ; Humans ; Oculomotor Muscles ; surgery ; Ophthalmologic Surgical Procedures ; methods ; Retrospective Studies ; Sclera ; surgery ; Strabismus ; surgery ; Treatment Outcome ; Visual Acuity

Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior rectus muscle. One week after the operation, torsional diplopia disappeared. However, a 4-prism diopter ipsilateral hypertropia was observed. Three months later, hypertropia gradually increased to 20 prism dioptors and the second operation was done to correct vertical diplopia.
Diplopia/etiology/physiopathology/surgery ; Eye Injuries/complications/*diagnosis/surgery ; *Eye Movements ; Humans ; Male ; Middle Aged ; Oculomotor Muscles/*injuries/physiopathology/surgery ; Ophthalmologic Surgical Procedures/*methods ; Strabismus/etiology/physiopathology/surgery ; Tendon Injuries/complications/*diagnosis/surgery

Extraocular muscle imbalance and diplopia after retina surgery have been previously reported, but the etiology is still controversial. In order to better understand the cause of strabismus after retinal surgery, the authors retrospectively studied 30 patients with persistent strabismus following retinal surgery and combined the result about seven patients of strabismus after retinal surgery in the previous report. Results showed multiple etiologies for the strabismus. Causes of strabismus included fat adherence syndrome (14 patients), non-specific restrictive adhesion (11), displacement of superior oblique tendon (2), scleral explant interfering with ocular motility (1), lost or slipped muscle with adhesion (2), sensory strabismus (2), macular pucker causing ectopic fovea (2), and previous strabismus before the retinal surgery (3). Knowledge of the varieties of abnormalities that can cause strabismus and diplopia will help both the retina and strabismus surgeon prevent and treat strabismus after retinal surgery.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diplopia/etiology ; Humans ; Middle Aged ; Oculomotor Muscles/pathology ; *Postoperative Complications ; Retina/*surgery ; Retinal Diseases/*surgery ; Retrospective Studies ; Strabismus/*etiology

Simulated Brown syndrome is a term applied to a myriad of disorders that cause a Brown syndrome-like motility. We encountered a case of acquired simulated Brown syndrome in a 41-year-old man following surgical repair of fractures of both medial orbital walls. He suffered from diplopia in primary gaze, associated with hypotropia of the affected eye. We performed an ipsilateral recession of the left inferior rectus muscle as a single-stage intraoperative adjustment procedure under topical anesthesia, rather than the direct approach to the superior oblique tendon. Postoperatively, the patient was asymptomatic in all diagnostic gaze positions.
Adult ; Anesthesia, Local ; Diplopia/*etiology/surgery ; Eye Movements ; Humans ; Male ; Ocular Motility Disorders/*etiology/radiography/surgery ; Oculomotor Muscles/surgery ; Ophthalmologic Surgical Procedures ; Orbital Fractures/radiography/*surgery ; *Postoperative Complications ; Strabismus/etiology/surgery ; Tomography, X-Ray Computed ; Vision, Binocular

In adjustable strabismus surgery, a satisfactory final result would be achieved with delayed adjustment. However, the postoperative adhesions following strabismus surgery make delayed adjustment impossible. We evaluated the efficacy of mitomycin C in reducing the severity of postoperative adhesions following strabismus surgery and in delaying the time adjustment after surgery. Experimental rabbits underwent a hang-back recession procedure in the superior rectus muscle. A topical application of mitomycin C was made between the conjunctiva and the sclera for 5 minutes during the operation. We then studied the possible time of delayed adjustment and estimated the minimal forces required for the adjustment. The topical application of 0.1 mg/ml mitomycin C between the conjunctiva and sclera allowed for a 2-week delayed adjustment after surgery, and 0.2 mg/ml mitomycin C prevented the adhesions between these tissues and the muscle 5 weeks after surgery. These results suggest that topical mitomycin C may enhance the success rate of strabismus surgery with delayed adjustment and reduce postoperative adhesions.
Administration, Topical ; Animals ; Chemotherapy, Adjuvant ; Conjunctiva/drug effects ; Mitomycin/administration & dosage/*pharmacology ; Oculomotor Muscles/drug effects/pathology/*surgery ; Ophthalmic Solutions ; Postoperative Complications/prevention & control ; Rabbits ; Sclera/drug effects ; Strabismus/drug therapy/pathology/*surgery ; Suture Techniques ; Tissue Adhesions/prevention & control

An animal experiment was done to evaluate the efficacy of tissue coating with sodium hyaluronic acid and subconjunctival injection of triamcinolone acetate in reducing the severity of postoperative adhesions following strabismus surgery. Experimental animals underwent a mild traumatic surgical procedure in one superior rectus muscle and a severe traumatic surgical procedure in the other superior rectus muscle. Each group was divided into control group, sodium hyaluronate coating group and triamcinolone acetonide injection group. Grading the severity of adhesions through surgical exploration of operative sites and histological comparison after 4 weeks revealed a significant reduction of postoperative adhesions in sodium hyaluronate group compared with control group under conditions of severe surgical trauma. But triamcinolone groups have no significant differences compared with control groups by statistical analysis. Tissue protection afforded by sodium hyaluronate may lead to an effective method which minimizes the surgical trauma to the tissues and reduces the postsurgical adhesions following strabismus surgery.
Animals ; Eye Diseases/etiology/*prevention & control ; Hyaluronic Acid/administration & dosage/*therapeutic use ; Injections ; Oculomotor Muscles/pathology ; Postoperative Complications/prevention & control ; Rabbits ; Strabismus/*surgery ; Tissue Adhesions/prevention & control ; Triamcinolone Acetonide/administration & dosage/therapeutic use ; Wound Healing