scholarly journals The efficacy of superior oblique posterior tenotomy in the treatment of A-pattern strabismus without ocular intorsion: A retrospective study

2020 ◽  
Author(s):  
Yan Wei ◽  
Ling-Yan Dong ◽  
Pei-quan Zhao ◽  
Xiao-li Kang
Keyword(s):  
Rectus Muscle ◽  
Ocular Motility ◽  
Ocular Torsion ◽  
Vertical Alignment ◽  
Primary Position ◽  
Pattern Deviation ◽  
The Mean ◽  
Fundus Photographs ◽  
Cover Test ◽  
Superior Oblique

Abstract Background: Superior oblique weakening is a common method to treat A-pattern strabismus. This study aims to evaluate the surgical results of the bilateral superior oblique posterior tenectomy procedure to treat A-pattern strabismus patients who had bilateral superior oblique overaction without objective ocular intorsion. Methods: The records of 18 consecutive patients who underwent surgery of superior oblique posterior tenectomy close to its insertion with superior oblique overaction (SOOA)-associated A-pattern strabismus between September 1, 2015 and August 31, 2018 were retrospectively reviewed. Ocular alignment, objective torsion, A-pattern and ocular motility were assessed. Ocular alignment was measured in the primary position, 25° upgaze, and 25° downgaze using the prism bar cover test, and torsion was measured using fundus photographs. Results: A total of 18 patients (mean age: 15 years; 6 female, 12 male) underwent bilateral superior oblique posterior tenectomy and simultaneous horizontal rectus muscle surgery were included. The mean preoperative A-pattern deviation was 15 PD and the mean postoperative A-pattern deviation was 2.25 PD with a mean reduction of 12.75 PD. The mean preoperative superior oblique overaction was 2.28 and the mean postoperative superior oblique overaction was 0.43 with a mean reduction of 1.85. There was no significant correlation between the ocular torsional, vertical alignment change and the superior oblique posterior tenectomy procedure. Conclusions: Superior oblique posterior tenectomy surgery selectively improved the A-pattern and superior oblique overaction but not affect the primary position vertical deviation, as well as the ocular torsion. It is an effective procedure to treat the mild to moderate superior oblique overaction associated A pattern strabismus without ocular intorsion.

scholarly journals The efficacy of superior oblique posterior tenectomy in the treatment of A-pattern exotropia without ocular intorsion: A retrospective study

2019 ◽  
Author(s):  
Yan Wei ◽  
Ling-Yan Dong ◽  
Xiao-li Kang ◽  
Pei-quan Zhao
Keyword(s):  
Rectus Muscle ◽  
Ocular Motility ◽  
Ocular Torsion ◽  
Primary Position ◽  
Horizontal Alignment ◽  
Pattern Deviation ◽  
The Mean ◽  
Fundus Photographs ◽  
Cover Test ◽  
Superior Oblique

Abstract Background: Superior oblique weakening is a common method to treat A-pattern strabismus. This study aims to evaluate the surgical results of the bilateral superior oblique posterior tenectomy procedure to treat A-pattern strabismus patients who had bilateral superior oblique overaction without objective ocular intorsion. Methods: The records of 18 consecutive patients who underwent surgery of superior oblique posterior tentomy close to its insertion with superior oblique overaction (SOOA)-associated A-pattern strabismus between September 1, 2015 and August 31, 2018 were retrospectively reviewed. Ocular alignment, objective torsion, A-pattern and ocular motility were assessed. Ocular alignment was measured in the primary position, 25° upgaze, and 25° downgaze using the prism bar cover test, and torsion was measured using fundus photographs. Results: A total of 18 patients (mean age: 15 years; 6 female, 12 male) underwent bilateral superior oblique posterior tenectomy and simultaneous horizontal rectus muscle surgery were included. The mean preoperative A-pattern deviation was 15 PD and the mean postoperative A-pattern deviation was 2.25 PD with a mean reduction of 12.75 PD. The mean preoperative superior oblique overaction was 2.28 and the mean postoperative superior oblique overaction was 0.43 with a mean reduction of 1.85. There was no significant correlation between the ocular torsional, vertical and horizontal alignment change and the superior oblique posterior tenectomy procedure. Conclusions: Superior oblique posterior tenectomy surgery selectively improved the A-pattern and superior oblique overaction but not affect the primary position vertical and horizontal deviation, as well as the ocular torsion. It is an effective procedure to treat the mild to moderate superior oblique overaction (SOOA)-associated A pattern strabismus without ocular intorsion.

scholarly journals The efficacy of superior oblique posterior tenotomy in the treatment of A-pattern strabismus without ocular intorsion: A retrospective study

2019 ◽  
Author(s):  
Yan Wei ◽  
Ling-Yan Dong ◽  
Xiao-li Kang
Keyword(s):  
Rectus Muscle ◽  
Ocular Motility ◽  
Ocular Torsion ◽  
Primary Position ◽  
Horizontal Alignment ◽  
Pattern Deviation ◽  
The Mean ◽  
Fundus Photographs ◽  
Cover Test ◽  
Superior Oblique

Abstract Background: Superior oblique weakening is a common method to treat A-pattern strabismus. This study aim to evaluate the surgical results of superior oblique posterior tenotomy procedures to treat A-pattern strabismus patients who had bilateral superior oblique overaction without ocular objective intorsion.Methods: The records of 18 consecutive patients who underwent surgery of superior oblique posterior tenotomy close to its insertion with superior oblique overaction (SOOA)-associated A-pattern strabismus between September 1, 2015 and August 31, 2018 were retrospectively reviewed. Ocular alignment, objective torsion, A-pattern and ocular motility were assessed. Ocular alignment was measured in the primary position, 25° upgaze, and 25° downgaze using the prism bar cover test, and torsion was measured using fundus photographs. Results: A total of 18 patients (mean age: 15 years; 6 female, 12 male) underwent bilateral superior oblique posterior tenotomy and simultaneous horizontal rectus muscle surgery were included. The mean preoperative A-pattern deviation was 15 PD and the mean postoperative A-pattern deviation was 2.25 PD with a mean reduction of 12.75 PD. The mean preoperative superior oblique overaction was 2.28 and the mean postoperative superior oblique overaction was 0.43 with a mean reduction of 1.85. There was no significant correlation between the ocular torsional, vertical and horizontal alignment change and the superior oblique posterior tenotomy procedure. Conclusions: Superior oblique posterior tenotomy surgery selectively improved the A-pattern and superior oblique overaction but not affect the primary position vertical and horizontal deviation, as well as the ocular torsion. So it is an effective procedure to treat the mild to moderate superior oblique overaction (SOOA)-associated A pattern strabismus without ocular intorsion.

scholarly journals Modified superior oblique intrasheath tenectomy in A-pattern with superior oblique overaction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunhua Sun ◽  
Ze Wang ◽  
Bo Xia
Keyword(s):  
Ocular Motility ◽  
Operating Microscope ◽  
Superior Rectus ◽  
Pattern Deviation ◽  
The Mean ◽  
Superior Oblique

Abstract Background To evaluate the effect of modified superior oblique intrasheath tenectomy (MSOIT) on superior oblique overaction (SOOA) with A-pattern. Methods We retrospectively reviewed the data of 66 patients (130 eyes) with SOOA and A-pattern underwent MSOIT at the nasal border of the superior rectus under an operating microscope between January 1, 2004 and December 31, 2018. The superior oblique (SO) tendon fibres were resected, and the sheath was preserved in all patients. The preoperative and postoperative SOOA, objective torsion, ocular motility, and A-pattern deviation findings were compared. The correlation between the preoperative A-pattern deviation and the corrected deviation was analysed. The average follow-up period was 33.45 ± 29.88 (range: 12–122) months. Results The mean SOOA deviation improved from 2.95 ± 0.54 to 0.34 ± 0.55 (P < 0.001), while the A-pattern deviation difference between upgaze and downgaze improved from 23.15 ± 7.59 prism diopters (PD) to 3.50 ± 2.90 PD (P < 0.001). The average objective fundus intorsion value improved from + 2.96 ± 0.58 to + 0.38 ± 0.60 (P < 0.001). The magnitude of correction in A-pattern was significantly correlated with the preoperative severity of A-pattern (r = 0.812, P < 0.001). Conclusions MSOIT at the nasal border of the superior rectus (SR) under an operating microscope is safe and yields beneficial outcomes in patients with SOOA and A-pattern.

scholarly journals Modified Superior Oblique Intrasheath Tenectomy in a-pattern With Superior Oblique Overaction  

2021 ◽  
Author(s):  
Chunhua Sun ◽  
Ze Wang ◽  
Bo Xia
Keyword(s):  
Ocular Motility ◽  
Operating Microscope ◽  
Superior Rectus ◽  
Pattern Deviation ◽  
The Mean ◽  
Superior Oblique

Abstract Background: To evaluate the effect of modified superior oblique intrasheath tenectomy (MSOIT) on superior oblique overaction (SOOA) with A-pattern.Methods: We retrospectively reviewed the data of 66 patients (130 eyes) with SOOA and A-pattern underwent MSOIT at the nasal border of the superior rectus under an operating microscope between January 1, 2004 and December 31, 2018.. The preoperative and postoperative SOOA, objective torsion, ocular motility, and A-pattern deviation findings were compared. The correlation between the preoperative A-pattern deviation and the corrected deviation was analysed. All patients were followed up for more than 12 months. Results: The superior oblique (SO) tendon fibres were resected, and the sheath was preserved in all patients. The average follow-up period was 33.45±29.88 (range: 12–122) months. The mean SOOA deviation improved from 2.95±0.54 to 0.34±0.55 (P < 0.001), while the A-pattern deviation difference between upgaze and downgaze improved from 23.15±7.64 prism dioptres (PD) to 3.50±2.90 PD (P < 0.001). The average objective fundus intorsion value improved from +2.96±0.58 to +0.38±0.60 (P < 0.001). The magnitude of correction in A-pattern was significantly correlated with the preoperative severity of A-pattern (r = 0.812, P<0.001).Conclusions: MSOIT at the nasal border of the superior rectus (SR) under an operating microscope is safe and yields beneficial outcomes in patients with SOOA and A-pattern.

scholarly journals Superior Oblique Myokymia Presumed Due to Large Posterior Fossa Arteriovenous Malformation

2020 ◽  
Vol 47 (6) ◽  
pp. 824-825
Author(s):  
Laura Donaldson ◽  
Brian van Adel ◽  
Amadeo R. Rodriguez
Keyword(s):  
High Frequency ◽  
Previous History ◽  
Ocular Motility ◽  
Slit Lamp ◽  
Primary Position ◽  
The Past ◽  
History Of ◽  
Supplementary Material ◽  
The Brain ◽  
Superior Oblique

A 26-year-old female presented with a complaint of intermittent oscillopsia and binocular vertical diplopia for the past 5 years. Over the past several months, she had noticed intermittent pulsatile tinnitus. She was otherwise healthy with no previous history of trauma and had no other visual or neurologic complaints. In Neuro-ophthalmology clinic, she was found to have 20/15 vision in both eyes with full ocular motility. There was a small exophoria in primary position and small esophoria in downgaze. Her slit lamp and fundus examinations were normal. During the assessment, the left eye was noted to undergo high-frequency, small amplitude incyclotorsional oscillations for a few seconds at a time (Video 1 in the supplementary material), which she was able to provoke by looking down. The diagnosis of superior oblique myokymia was made, and an MRI/MRA of the brain was requested.

A single inferior rectus muscle surgery for treatment of congenital superior oblique palsy with small deviation in primary position

2021 ◽  
pp. 112067212110143
Author(s):  
Lijuan Huang ◽  
Yuyu Wu ◽  
Ningdong Li
Keyword(s):  
Rectus Muscle ◽  
Head Position ◽  
Superior Oblique Palsy ◽  
Inferior Rectus ◽  
Primary Position ◽  
Class V ◽  
Abnormal Head ◽  
Inferior Rectus Muscle ◽  
Superior Oblique

Purpose: To evaluate outcomes of one muscle surgery for treatment of congenital superior oblique palsy (SOP) with Knapp Class V. Methods: Medical records were retrospectively reviewed for the patients with the congenital SOP type V who underwent surgical treatment through one muscle surgery between July 2015 and September 2020. The surgical procedure was resection-recession on the contralateral inferior rectus muscle of the hypertrophic or paretic eye. Vertical alignment at nine cardinal gaze positions, and resolution of the abnormal head posture were evaluated pre- and postoperatively. The follow-up was scheduled regularly at postoperative day 1, 1 week, 1 month, and followed by 2-month intervals until 18 months. Results: Twelve patients were included in this study, with a mean age of 6.4 years (range from 3 to 10 years). The mean follow-up period was 10.5 months after surgery (range from 6 to 18 months). The average vertical deviation at primary position was 6.33△ ± 2.93△ preoperatively and 0.75△ ± 1.14△ postoperatively ( p < 0.05). The average vertical deviation at downgaze was 23.33△ ± 4.75△ preoperatively and 1.92△ ± 1.62△ postoperatively ( p < 0.05). All patients had an abnormal head position preoperatively. Postoperative results indicated that the patients’ abnormal head position had been improved significantly. Conclusions: The surgical procedure of resection-recession on a single inferior rectus muscle is a successful intervention for the correction of superior oblique palsy (SOP) with Knapp Class V.

scholarly journals The Effects of Modified Graded Recession, Anteriorization and Myectomy of Inferior Oblique Muscles on Superior Oblique Muscle Palsy

2021 ◽  
Vol 10 (19) ◽  
pp. 4433
Author(s):  
Yu-Te Huang ◽  
Jamie Jiin-Yi Chen ◽  
Ming-Yen Wu ◽  
Peng-Tai Tien ◽  
Yung-Ping Tsui ◽  
...  
Keyword(s):  
Torsion Angle ◽  
Head Tilt ◽  
Rectus Muscle ◽  
Clinical Results ◽  
Oblique Muscle ◽  
Torsional Angle ◽  
Ocular Torsion ◽  
Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Background: The aim was to investigate the effect of inferior oblique (IO) operation (IO myectomy or graded recession and anteriorization) for unilateral and bilateral superior oblique muscle palsy (SOP); Methods: A total of 167 eyes undergoing IO surgery by a single surgeon between 2008 and 2015 were retrospectively reviewed. The method for treating symmetric bilateral SOP was bilateral IO myectomy (n = 102) and the method for treating unilateral SOP or non-symmetric bilateral SOP was IO-graded recession and anteriorization (n = 65). Associated clinical results and other factors were analyzed; Results: Head tilt, vertical deviation, IO overaction, SO underaction degree and ocular torsion angle were all clearly changed, but there was no statistically significance between these two procedures. Mean preoperative torsional angle was 15.3 ± 6.4 degree, which decreased to 5.3 ± 2.7 degree after surgery. Preoperative torsional angle, IOOA and SOUA degree were all significantly affected in postoperative torsional angle (p = 0.025, 0.003 and 0.038). Horizontal rectus muscle and IO muscle operation did not interfere with each other’s results (p = 0.98); Conclusions: Symmetric bilateral SOP could be treated with bilateral IO myectomy and IO-graded recession and anteriorization should be reserved for unilateral SOP or non-symmetric bilateral SOP.

Strabismus Surgery of Consecutive Exotropia

2020 ◽  
Vol 237 (04) ◽  
pp. 506-509
Author(s):  
Lucas Janeschitz-Kriegl ◽  
Francoise Roulez ◽  
Monika Marina Wipf ◽  
Anja Palmowski-Wolfe
Keyword(s):  
Strabismus Surgery ◽  
Dose Effect ◽  
Primary Position ◽  
Post Surgery ◽  
Initial Surgery ◽  
Number Of Patients ◽  
Consecutive Exotropia ◽  
Angle Of Deviation ◽  
The Mean ◽  
Cover Test

Abstract Purpose The purpose of this study was to determine the surgical outcome, dose-effect (DE), and degree of binocularity in patients undergoing surgery for consecutive exotropia following initial surgery of esotropia. Patients/Methods Twenty-one patients were identified. We analyzed the mean angle of deviation pre- and postoperatively as measured with the alternate prism cover test, DE, and binocularity. Results All patients had had previous strabismus surgery. The surgery for consecutive exotropia had been performed at a mean age of 35.92 ± 18.26 years. In 19 of these patients, surgery of consecutive exotropia involved at least one previously operated extraocular muscle, and the mean interval to the previous surgery was 25.67 ± 16.14 years. The mean angle of deviation (DE) at distance and in the primary position was − 33.43 ± 12.75 prism diopters (PD) preoperatively, + 0.76 ± 7.91 PD 1 week after surgery, and − 7.24 ± 12.14 PD 3 months after surgery. The mean DE was 3.58 ± 1.53 mm/PD at 1 week and 2.70 ± 1.78 mm/PD at 3 months post-surgery. Postoperatively, 62% patients had a binocularity of at least Bagolini positive, 33% had either a positive TNO or Titmus Test, and 24% were Lang I positive (550″). Conclusion Performing strabismus surgery with consecutive exotropia results in restoration of some binocularity in a large number of patients, even in adults, and should be considered as a possibility. The dose-effect is comparable to conventional surgery of exotropia.

scholarly journals The Effect of Inferior Rectus Muscle Thickening on Intraocular Pressure in Thyroid-Associated Ophthalmopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Xiuhong Li ◽  
Xu Bai ◽  
Zhibin Liu ◽  
Ming Cheng ◽  
Jia Li ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Rectus Muscle ◽  
Control Group ◽  
Movement Restriction ◽  
Inferior Rectus ◽  
Primary Position ◽  
Normal Individuals ◽  
Thyroid Associated Ophthalmopathy ◽  
The Mean ◽  
Inferior Rectus Muscle

Objective. We aimed to evaluate the effect of inferior rectus muscle thickening on intraocular pressure (IOP) in patients with thyroid-associated ophthalmopathy (TAO). Materials and Methods. We analyzed 33 patients with TAO (50 eyes) who presented with hypotropia in the primary position. There was significant eyeball movement restriction and inferior rectus muscle thickening was confirmed on computed tomography or magnetic resonance imaging. We measured IOP changes in patients with TAO and normal participants in the primary position and upgaze using Icare tonometer. Moreover, we measured the preoperative and postoperative IOP in 13 patients with hypotropia who underwent inferior rectus recession. Results. The average inferior rectus thickness in the TAO and control groups was 0.71 ± 0.13 mm and 0.36 ± 0.12 mm, respectively. In the TAO group, the mean IOP was 16.8 ± 2.1 mm Hg in primary position (hypotropia), which increased by 8.9 ± 2.7 mm Hg to 25.7 ± 3.1 mm Hg in upgaze (horizontal vision). In the control group, the mean IOP in the primary position (horizontal vision) was 15.1 ± 1.9 mm Hg, which increased by 2.5 ± 1.4 mm Hg to 17.6 ± 2.1 mm Hg in upgaze. Compared with normal participants, patients with TAO who presented inferior rectus muscle thickening had a significantly greater increase in the IOP P < 0.0001 . In the patients with TAO who underwent inferior rectus muscle recession, there was a postoperative reduction in the IOP in the horizontal vision by 9.4 ± 5.2 mm Hg. Conclusion. Inferior rectus muscle thickening in patients with TAO causes a significant increase in the IOP upon upgaze compared to that in normal individuals. Given the ease of misdiagnosis as glaucoma, IOP measurement in patients with TAO should be performed in the primary position.

scholarly journals Isolated rectus muscle rupture following trauma

2016 ◽  
Vol 7 (2) ◽  
pp. 182-185 ◽  
Author(s):  
Halil Hüseyin Çağatay ◽  
Metin Ekinci ◽  
Şendoğan Ulusal ◽  
Mehmet Ersin Oba ◽  
Zeliha Yazar
Keyword(s):  
Treatment Options ◽  
Rectus Muscle ◽  
Inferior Rectus ◽  
Primary Position ◽  
Initial Surgery ◽  
Muscle Rupture ◽  
The Right ◽  
Periorbital Swelling ◽  
Cover Test

Background: Isolated rectus muscle ruptures are rare ophthalmic emergencies which may result in permanent diplopia. Objective: To highlight updates on clinical features, surgical treatment options and potential complications for isolated inferior rectus ruptures. Case: A 39-year-old man came to our emergency department complaining of diplopia and upward deviation of the right eye after experiencing an animal injury. Extraocular movements were limited in the right eye in the downgaze position. The alternate prism and cover test, both at distance and near testing, showed hypertropia of 40 prism diopters (PD) of the right eye. The right eye had periorbital swelling and conjunctival haematoma. An inferior rectus rupture repair was performed under local anesthesia and monitored sedation. Follow-up examination revealed a 20 PD hypertropia, causing diplopia in all gazes. A second surgical intervention was planned six months after the initial surgery, an inferior rectus 6 mm resection was performed, after which orthophoria was achieved in the primary position both at distance and near testing. 

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