Long-term surgical results for 3 or 4 horizontal muscles surgery were evaluated in 58 infantile esotropes with large angle of 55 PD or more. They were followed up for 2 years or more(mean 5.6+/-2.16 years). The mean preoperative deviation was 63.2(+/-5.30)PD, ranging from 55 to 75 PD. Monocular preference was shown in fifty seven percent(34 patients)at the first visit. Thirty eight patients(65.5%)were aligned within+/-8 PD of orthotropia after primary procedure and forty nine patients(84.5%)after the second operation. The immediate postoperative deviation averaged 4.8+/8.99 PD of exotropia in 38 patients all of whom were aligned within+/-8 PD of orthotropia at the last visit. Prospectively, the patients with immediate overcorrection of 4 to 9 PD of orthotropia after surgery were found to be mostly aligned within 8 PD of orthotropia at the last visit. Among the 49 patients with stereopsis testing, 29 patients(58%)had measurable stereopsis and 70%of these patients had favorable stereopsis of 800 seconds or less. In conclusion, 3 or 4 horizontal muscles surgery was effective as initial procedure in large angle infantile esotropia with 55 PD or more deviation. Small amount of exotropia less than 10 PD in the immediate postoperative period was desirable for the best long-term alignment.
Depth Perception ; Esotropia* ; Exotropia ; Humans ; Muscles* ; Postoperative Period ; Prospective Studies

The histopathological changes were observed to evaluate the effect of single intraopferative application of mitomycin C soaked Cottonoid on wound healing process after strabismus surgery. A 3mm recession of the superior rectus muscle was performed after application of 0.5mg/ml mitomycin C soaked Cottonoid for 5 minutes in one eye of 15 rabbits(30 eyes) and was copiously irrigated with normal saline. The same procedure was done in the contralateral eye as a control using normal saline. The less amount of inflammatory cellular infiltration and the less granulomatous reaction to suture material were observed in mitomycin C treated eyes. The proliferation of fibroblast was considerably inhibited in mitomycin C-treated group. The postoperative adhesion, the fibrosis of extrocular muscle and the depositon of collagen fibers were also decreased in mitomycin C-treated group. Gross complications was not present in rabbit during 3 months of experiment. No pathologic sign of undesirable side effects was noted. In conclusion, the single intraoperative application of mitomycin C soaked Cottonoid could decrease the postoperative adhesion and extraocular muscle fibrosis through its inhibitory effects on the inflammatory reaction and fibroblast proliferation in strabismus surgery without any complications which were reported in subconjunctival injection of mitomycin C. Further studies investigating the optimal concentration, application method and time of mitomycin C soaked Cottonoid and its promising potential for use in humans are needed.
Collagen ; Fibroblasts ; Fibrosis ; Humans ; Mitomycin* ; Strabismus ; Sutures ; Wound Healing* ; Wounds and Injuries*

The commonly used tests for stereopsis are Titmus-fly, Randot, and TNO tests. In this study, 50 normal subjects were tested with these tests in order to set a criterion for normal stereopsis. The value of mean, mode and 75% point of these three tests were derived and compared.These three tests were also performed in 23 intermittent exotropes and 32 accommodative esotropes who showed gross stereopsis in the range of 60 to 400 seconds of arc by Titmus-fly testing. The aim was to obtain standards for clinical applicability and accuracy of these tests.This study cincludes that the appropriate criteria for normal stereopsis are less than 60 seconds of arc for Titmus-fly or Randot test, and 120 seconds of arc fot TNO test. Accurate testing for stereopsis in patients with gross stereopsis requires both Titmus-fly and Randot tests together. TNO test was inferior to the other two tests in terms of the accuracy and clinical applicability.
Depth Perception ; Humans

Good compliance of patching therapy is essential to improve visual acuity in amblyopia. The author investigated the compliance and effective method of occlusion therapy for amblyopia by questionair given to the patients and their parents. For better compliance and the duration of patching and the best time for its performance should be controlled according to patients' character and age. It was shown that the younger the age, the better the compliance of patching therapy. It was important that early diagnosis for amblyopia made and early treatment should be initiated before 6 years of age, beeause the compliance of patching therapy was much decreased in patients above six years of age. Physicians should ensure full understanding of amblyopia in patients and their parents, especially mothers, before patching therapy begins. Continued and steady patching could considerably improve visual acuity in ehildren older than eight years of age.
Amblyopia* ; Compliance* ; Early Diagnosis ; Humans ; Mothers ; Parents ; Visual Acuity

The recurrent pterygium can be caused by repeating excisions for simple pterygium. The severe conjunctival cicatrization on the area of the medial rectus muscle limits abduction and results in diplopia and it is one of the causes of acquired retraction syndrome. We experienced two patients who have marked abducticn limitation and diplopia in all directions of gaze by recurrent pterygium. In order to eliminate these troblesome symptoms and signs with only one surgery, we performed conjunctival autograft transplantation in one patient and on the other patient with bilateral recurrent pterygium, the procedure was performed with resection of the lateral rectus using adjustable suture at one time. The limitation of ocular movement and diplopia were completely gone postoperatively.
Autografts ; Cicatrix ; Diplopia ; Duane Retraction Syndrome ; Esotropia* ; Humans ; Pterygium* ; Sutures

It is reported that the recurrence rate in intermittent exotropia is 20-50%. In this study, we evaluated whether the recurrence is reduced with asymmetric recession of bilateral lateral recti(LROU) in intermittent exotropia.Twenty-nine patients underwent the asymmetric LROU recession for intermittent exotropia with follow-up of 6-54 months. The amount of recession of lateral rectus muscle in deviating eye was 2mm more than in the fixating eye. Immediate postoperative overcorrection, the rate of orthophotia, and the occurrence of consecutive esotropia(ET) were analysed.The mean amount of immediate postoperative esodeviation was 16.5+/-7.4PD(0-34PD); four patients showed 0-4PD, 18 patients 11-20PD, and 7 patients showed considerable amount of ET as high as 21-30PD. Consecutive EToccurred in 6.8% of patients despite large amounts of postoeprative ET. The outcome of orthophoria was favorable, in 93.1% of patients in follow up of 6 months, 85.1% in 12 months and 78.5% in 24 months.This study suggests that asymmetric LROU recession is an effective procedure for the correction of intermittent exotropia.
Esotropia ; Exotropia* ; Follow-Up Studies ; Humans ; Recurrence

The use of succinylcholine chloride(Anectin(R)) prior to intubation, can cause increased contracture of ocular muscles. Therefore the authors studied the change of the squint angle under general anesthesia using pancronium bromide (Myoblock(R)) in 81 horizontal strabismus patients who had no neurologic disease and mechanical restrictions of eye movement. We used the alternative cover test and Krimsky method to measure the eye position under general anesthesia.
Anesthesia ; Anesthesia, General* ; Contracture ; Eye Movements ; Humans ; Intubation ; Muscles ; Strabismus* ; Succinylcholine

It. has been reported that, subconjunctival mitornycin c is strongiy effective in the reduction of postoperative fibrosis and adhesion. However we have to be cautious in using it clinically because of severe complications, scleral necrosis, endophthalmitis, etc. To find out the adequate concentration of mitomycin C, the authors performed 3mm recession of the superior rectus muscle (SR) in the left sys of 24 rabbits which were divided into 4 groups. Each group was composed of 6 rabbits. The 0.1%of 0.9% normal saline, 0.005% 0.01%, and 0.02% mitomycin c were injected subcounctivally through the site of SR recession in each group, respectively. The severity of the adhesion between SR and its surrounding tissues and the reduction of fibroblast. proliferation were evaluated histopathologically with the light microscope one month after surgery. The 0.01% and 0.02%mitomycin C-injected groups demonstrated considerable inhibition of postoperative adhesion and fibroblastic proliferation (p<0.05 and P<0.01, respectively) . However the 0. 005% mitomycin c was not. effective in the reduction of postoperative adhesion (P>0. 15), This study reveals that the concentration of mitomycin c between 0.01% and 0.02% may prevent postoperative adhesions effectively after strabisrnus surgery. Further studies are needed to demonstrate the lowest concentration of mitoniycin c to prevent postoperative adhesion effectively without any com.plicat.ions in clinical use.
Endophthalmitis ; Fibroblasts ; Fibrosis ; Mitomycin* ; Necrosis ; Rabbits

PURPOSE: Long-term alignment after bimedial recti recessions for infantile esotropia were evaluated in 51 infantile esotropes with angle less than 55 PD. All patients were followed up for more than 2 years (Mean 4.5+/-2.0 years). METHODS: All the patients'charts were reviewed retrospectively. They were divided into three groups as follows: 1) orthophoria within +/-8PD, 2) esotropia, and 3) exotropia by final alignment. In each group, immediate postoperative angle of deviation, success rate and stereopsis were evaluated. And the relation between final alignment and immediate postoperative angle of deviation were studied. RESULTS: The mean preoperative deviation of all patients was 44.1+/-6.67 PD (22~54 PD). Monocular preference was shown in 49.1% (25 patients) at the initial visit. Twenty-eight patients (54.9%) were aligned within +/-8 PD of orthotropia after initial surgery and forty-three patients (83.4%) after the second operation. The immediate postoperative deviation averaged 1.2+/-5.17% PD of exotropia in 28 patients who were aligned within +/-8 PD of orthotropia at the last visit. The patients with deviation of +/-3PD immediately after surgery were found to be mostly aligned within +/-8 PD of orthotropia at the last visit (51.7%, p=0.07). Thirty-one of 42 patients (73.8%) had measurable stereopsis and 47.6% of these patients favorable stereopsis better than 800 seconds of arc. The most satisfactory results in the obtaining stereopsis was shown in the patients undergoing surgery between 1~2 years of age. CONCLUSIONS: Bimedial recti recessions for infantile esotropia less than 55 PD were effective as an initial procedure in long-term follow-up for more than 2 years. Orthotropia within +/-3 PD in the immediate postoperative period was desirable for the long-term alignment. Binocularity was best obtained by undergoing early surgery between 1~2 years of age.
Depth Perception ; Esotropia* ; Exotropia ; Follow-Up Studies ; Humans ; Postoperative Period ; Retrospective Studies ; Telescopes

We studied the relationship of deviated eye with dominant eye, dominant hand and visual acuity in 109 horizontal strabismic patients. Control group of 109 normal subjects without strabismus or specific ocular diseases were also examined. Right ocular dominance in normal subjects was noted in 66.1%. Strabismic patients showed ocular dominance of nondeviated eye in 78.5%. The dominance of right hand in normal subjects were noted in 89.0% and those were 82.6% in strabismic patients. Better visual acuity of right eye were noted in 40.4% of normal subjects, and 28.4% in left eye. Equal visual acuity between two eyes were 31.2% of the subjects. Strabismic patients showed better visual acuity in 70.9% of nondevia ted eye. Based on these results, the correlation of nondeviated eye with dominant eye, and better visual acuity were statistically significant(p<0.01, respectively), but not with dominant hand(p>0.05).
Dominance, Ocular ; Hand* ; Humans ; Strabismus* ; Visual Acuity