We attempted to predict the success, undercorrection, overcorrection rate at postoperative 1 year by examining alignment at postoperative 1 day and find out the relationship between alignment of postoperative 1 day and 1year. Forty-six patients with intermittent exotropia underwent bilateral lateral rectus recession at Keimyung university, Dongsan medical center and fifty-seven patients underwent unilateral medial rectus resection and lateral rectus recession at Catholic university, St.Mary`s hospital. The alignment at postoperative 1 day was classified as the overcorrected with 11-20PD, the overcorrected with 1-10PD,the orthotropia, and the undercorrected with residual exotropia of 1-10PD. There was a statistically significant relationship between alignment at postoperative 1 day and 1 year in unilateral medial rectus resection and lateral rectus recession and bilateral lateral rectus recession (r=0.74, r=0.51, p<0.05). Those patients who were overcorrected 1-20PD had a significantly higher success rate than those undercorrected 1-10PD at postoperative 1 day (p<0.05). In the unilateral medial rectus resection and lateral rectus recession group,postoperative 1 day alignment of 1-10PD resulted in the highest success rate of 73.7%. In the bilateral lateral rectus recession group,postoperative 1 day alignment of 11-20PD showed the highest success rate of 76.9%. There were no significant differences in the success rate,undercorrection rate, and overcorrection rate between the two kinds of surgery at postoperative 1 year. As a result, the alignment at postoperative 1 day can be one of the predictive factors of future surgical outcome. The initial postoperative overcorrection of 11-20PD in bilateral lateral rectus recession and overcorrection of 1-10PD in unilateral medial rectus resection and lateral rectus recession can lead to good results.
Exotropia ; Humans

PURPOSE: This study examines the change in distance from the corneal limbus to the insertion of the rectus muscles before and after disinsertion and retraction with a pair of fixation forceps during strabismus surgery. METHODS: In 38 strabismus patients, on 30 medial rectus muscles and 38 lateral rectus muscles, before and after disinsertion and retraction with a pair of fixation forceps, the distances from the corneal limbus to the upper, middle and lower parts of the insertion of the medial and lateral rectus muscles marked with methylene blue solution were measured. RESULTS: The distances between the corneal limbus and upper, middle and lower parts of the insertion after the disinsertion were reduced on, average 0.23 mm, 0.28 mm, and 0.18 mm, for the medial rectus muscle, respectively, and 0.21 mm, 0.28 mm, and 0.15 mm, for the lateral rectus muscle, respectively (P<0.05). The percentage of cases in which the advance from the corneal limbus to the insertion was greater than 0.5 mm was 33.3% for the medial rectus muscle, and 21.1% for the lateral rectus muscle. The lateral rectus muscle was disinserted, fixed with a pair of forceps, and subsequently, the distance from the upper, middle and lower parts to the corneal limbus were reduced to 0.36 mm, 0.43 mm, and 0.30 mm, respectively (P<0.05). The percentage of cases that advanced more than 1.0 mm was 13.2 %. The changes in distance from the upper, middle, and lower parts of insertion toward the limbus after disinsertion and retraction were 0.15 mm 0.15 mm, 0.16 mm, respectively (P<0.05). CONCLUSIONS: When performing the recession of the lateral rectus muscle, disinsertion of the rectus muscle, may result in a change of the site of insertion, which in turn might influence the outcome of strabismus surgery.
Humans ; Limbus Corneae ; Methylene Blue ; Muscles* ; Strabismus ; Surgical Instruments

No abstract available.
Paranasal Sinus Neoplasms*

No abstract available.
Humans*

PURPOSE: We report a case of Type 3 Waardenburg syndrome accompanied by intermittent exotropia, which had not previously been encountered in Korea along with the literature study. METHODS: A 5-year-old boy visited as a result of hypochromic heterochromic iridum in the right eye. Suspecting Type 3 Waardenburg syndrome, plain radiography, a hearing test, an alternate prism cover test and fundus examinations were performed and the presence of lateral displacement of the lacrimal puntum was evaluated. RESULTS: The presence of hypochromic heterochromic iridum, dysplasia of the left thumb, sensorineural deafness, dystopia canthorum along with a lateral displacement of the lacrimal puntum, albinism of the posterior pole upon a fundus examination, and intermittent exotropia with a 20 prism diopters of deviation were found. CONCLUSIONS: This patient showed the 4 criteria for a diagnosis of Type 3 Waardenburg syndrome including hypochromic heterochromic iridum, dystopia canthorum along with lateral displacement of the lacrimal puntum, sensorineural deafness, and a muscular system abnormality, i.e., dysplasia of the left thumb. He also showed intermittent exotropia.
Albinism ; Child, Preschool ; Deafness ; Diagnosis ; Exotropia ; Hearing Tests ; Humans ; Korea ; Male ; Radiography ; Thumb ; Waardenburg Syndrome*

PURPOSE: To investigate the clinical outcomes of unilateral lateral rectus muscle advancement in patients with consecutive esotropia after bilateral lateral rectus muscle recession. METHODS: We investigated the results of 13 patients who underwent unilateral lateral rectus muscle advancement for consecutive esotropia after bilateral lateral rectus muscle recession. We evaluated the amount of deviation, changes of angle deviation, corrected amount/mm, and sensory status after each surgery. RESULTS: The average angle deviation of exotropia was 30.42+/-5.41PD, and the average amount of bilateral lateral rectus muscle recession was 6.73+/-0.59 mm. The average angle deviation of esotropia one day after the surgery was 13.17+/-5.15PD. Occlusion treatment was performed during follow-up. The surgery for consecutive esotropia was performed after an average of 12.0+/-7.25 months of follow-up. In Worth-4-dot tests, 12 patients showed diplopia, and 1 patient showed suppression after the surgery for exotropia. Nine patients showed diplopia, and 4 patients showed suppression just before the surgery for consecutive esotropia. One patient showed mild limitation of motion of the lateral rectus muscle (-1 degree). The average angle deviation before the surgery for consecutive esotropia was 19.42+/-4.20PD. An average of 6.73+/-0.79 mm of unilateral lateral rectus muscle advancement was performed. After surgery, the average angle deviation was 1.25+/-2.73PD esodeviation, and 1.42+/-4.44PD exodeviation after 6 months. In Worth-4-dot tests, 6 patients showed fusion, 2 patients showed diplopia, and 5 patients showed suppression after surgery for consecutive esotropia. CONCLUSIONS: Unilateral lateral rectus muscle advancement was an effective procedure for patients with consecutive esotropia under 25PD who did not show any limitation of motion after bilateral lateral rectus recession.
Diplopia ; Esotropia ; Exotropia ; Follow-Up Studies ; Humans ; Muscles

PURPOSE: The purpose of this study is to evaluate sensory function and stereoacuity in patients showing orthophoria after surgery in exotropes, and to elucidate factors influencing postoperative improved sensory status METHODS: We prospectively studied 45 patients showing orthophoria or exophoria within 4 prism diopters after strabismic surgery in exotropes. Three tests (Worth-4-dot test, Bagolini striated lens test and Titmus test) were performed at pre and postoperative period. We studied the effect of different variables (age at surgery, visual acuity, angle of deviation, Bagolini striated lens test, Titmus test, anisometropia, and fusional status) with suspected clinical influence on the sensory and motor outcomes. RESULTS: In Worth-4-dot test, 34 patients (75.6%) showed improvement after surgery. Thirty-three patients (73.3%) and 35 patients (77.8%) showed improvement respectively in the Bagolini striated lens test and Titmus test. Thirty-eight patients showed improvement in 2 or more tests after surgery and 7 patients showed no change. Of patients showing preoperative abnormal response in each test, 21 patients (65.6%) in Worth-4-dot test, 14 patients (53.8%) in Bagolini striated lens test, and 22 patients (68.8%) in Titmus test showed normal response at postoperative 6 months. Of 3 tests and other factors, Bagolini striated lens test was the only factor predicting postoperative sensory recovery (x2=4.18, P<0.05). CONCLUSIONS: In patients showing orthophoria or exophoria within 4 prism diopters after strabismic surgery in exotropes, Bagolini striated lens test was the only meaningful factor predicting postoperative sensory recovery
Anisometropia ; Exotropia ; Humans ; Postoperative Period ; Prospective Studies ; Sensation ; Strabismus* ; Visual Acuity

PURPOSE: It is known that fusion is promoted in the presence of a peripheral fusion clue in patients with intermittent exotropia, X(T). Therefore, this study compared the results of the Worth 4-dot test (W4D) with the room lights on and off in order to determine the status of the binocular function. METHODS: The W4D test was performed with lights on and off, and the polarized 4-dot test (P4D) was administered in 52 X(T) patients. RESULTS: Among these 3 tests, the fusion rate was the lowest with distance in the W4D with the lights off at 9.6%, which was followed by the W4D with the lights on at 26.9% and the P4D at 57.7%. The fusion rate of the W4D with the lights on in the patients with a distance stereoacuity better than 120 seconds of arc (") was 50%, which was significantly higher than the 18.4% observed in the patients with a stereoacuity at 120" or worse (P=0.023). Among the 14 patients who showed fusion with the distance W4D with the lights on, 10 could not fused with the W4D with the lights off. Therefore, a weak motor fusion was observed in 71.4 % of these 14 patients. CONCLUSIONS: It is possible to verify the more natural condition of the binocular sensory function of patients with X(T) using either the P4D or the W4D with the lights on rather than with the lights off. Furthermore, the W4D test with the lights on can be performed together with and be compared with that conducted with the lights off, for a better understand of the degree of motor fusion.
Exotropia ; Humans ; Sensation ; Telescopes

Agenesis of trachea is a rare congenital anomaly. The main signs are respiratory distress, cyanosis, inability to vocalise and impossible tracheal intubation. There is no long-term surgical solution at present, therefore the condition is ultimately fatal. We report a case of tracheal agenesis. We anesthetized a 2.25 kg neonate for endoscopic examination, who was intubated successfully. Beyond 2.5 cm from the vocal cord, there was no trachea and we can only see esophageal lumen with fistula opening. After the endoscopic examination, exploratory thoracotomy was done, but surgical correction was impossible. After the surgery, she died from progressive ventilatory failure. Autopsy revealed a Floyd's type II tracheal agenesis with tracheo-esophageal fistula.
Autopsy ; Cyanosis ; Fistula ; Humans ; Infant, Newborn ; Intubation ; Thoracotomy ; Trachea ; Vocal Cords

PURPOSE: To evaluate the degree and change in refractive error and the relation of refractive error, the angle of deviation and amblyopia in patient with refractive accommodative esotropia. METHODS: Children with refractive accommodative esotropia were retrospectively included in the study. The factor studied were sex, age at the first visit, ocular alignment, refractive error and amblyopia. RESULTS: The average age at the first visit was 4.01+/-1.86 years. And, the average angle of esodeviation was 22.23+/-13.74PD for the near and 21.51+/-12.01PD for the distant. The average manifest and cycloplegic refraction measured at patient's first visit were +2.35+/-2.87D and +4.87+/-1.77D respectively. The difference between cycloplegic and manifest refraction decreased gradually. After 3 years, the average manifest and cycloplegic refraction were +3.42+/-1.80PD and +4.33+/-1.77D. The refractive error didn't significantly affect the degree of esodeviation (r=0.051). Twenty-three of patients were amblyopia. The refraction of amblyopic and non amblyopic patient was +5.07+/-1.85D and +4.50+/-2.47D, respectively. However, this difference was not statistically significant. CONCLUSIONS: Mean cycloplegic refraction decreased significantly over a 3-year period. After full correction with glasses, the difference between cycloplegic and manifest refraction decreased. The refractive error was not associated with the degree of deviation anlge, amblyopia occurrence and treatment success.
Amblyopia ; Child ; Esotropia* ; Eyeglasses ; Glass ; Humans ; Refractive Errors* ; Retrospective Studies