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Purpose: To evaluate the correlation between the angle of deviation in different gazes and the amount of head tilt in patients with congenital unilateral superior oblique muscle palsy (SOP). Methods: This case series study was performed on 20 consecutive SOP patients with head tilt. Based on the Bielschowsky three-step test, the angle of deviation was measured in different gazes. Furthermore, the hypertropia difference between the two lateral gazes (gaze difference) and the two head tilt sides (bilateral head tilt difference) was calculated. For measuring head tilt, close-up pictures from 40 cm with a habitual abnormal head position were captured and analyzed by the Corel Draw X7 software. Results: The mean age of patients was 13 ± 9 years (range, 2.5–31 years). The mean angle of hypertropia in ipsilateral and contralateral head tilt was 24.5 Δ ± 7.1 Δ and 6.5 Δ ± 4.2 Δ, respectively (P < 0.001), and in ipsilateral and contralateral lateral gaze positions, it was 8.2 Δ ± 5.5 Δ and 22.5 Δ ± 6.1 Δ, respectively (P < 0.001). The mean of bilateral head tilt hypertropia difference was 18 Δ ± 5.3 Δ and gaze hypertropia difference was 14.3 Δ ± 6.16 Δ. There was a positive correlation between bilateral head tilt hypertropia difference and the amount of head tilt (R = 0.609, R2 = 0.371, P = 0.004, the amount of head tilt = 0.39 × [Bilateral head tilt hypertropia difference] +1.77). The amount of head tilt also had a positive correlation with the gaze hypertropia difference (R = 0.492, R2 = 0.242, P = 0.028, the amount of head tilt = 0.27 × [gaze hypertropia difference] +4.81). Conclusion: In SOP patients, the amount of head tilt had a positive correlation with bilateral head tilt hypertropia difference and also gaze hypertropia difference.

Goal. Development of the main provisions of the theory of plane-parallel motion of an asymmetric haulm-harvesting unit, which will allow further numerical modeling on a PC of its optimal kinematic and design parameters, which will increase the stability of the technological process of sugar beet harvesting. Methods. During the study, methods were used to build computational mathematical models of agricultural machines and machine units, based on theoretical mechanics, higher mathematics, and the basics of the theory of automatic control. The transformations and simplifications of the obtained differential equations of motion are aimed at their further use for numerical calculations on the PC. Results. As a result of the analytical study, an equivalent scheme was constructed, based on which a calculated mathematical model of the plane-parallel motion of an asymmetric haulm-harvesting unit in the horizontal plane was developed, provided that the wheel tractor and rear trailer coupling is connected by a cylindrical hinge. According to the results of mathematical modeling, a new system of linear differential equations of the second order is obtained, which describes the transverse movement of the center of mass of a wheeled tractor and rotation of its longitudinal axis of symmetry by a certain angle around the specified center of mass, as well as the angle of deviation of the trailed haulm-harvesting unit from the longitudinal axis of symmetry of the tractor at any time. Conclusions. An equivalent scheme is constructed, based on which the calculated mathematical model of plane-parallel motion in the horizontal plane of the asymmetric haulm-harvesting unit is developed. A new system of linear differential equations of the second order is obtained, which describes the transverse displacement of the center of mass of the wheeled tractor, as well as the angle of deviation of the trailed haulm-harvesting unit from the longitudinal axis of the tractor at any time. Based on the obtained system of differential equations it is possible to study the stability of the asymmetric haulm-harvesting machine-tractor unit when performing the technological process of sugar beet harvesting.

Monofixation syndrome (MFS) is a specific subnormal binocular vision status, either with or without a small deviation. Patients with MFS have a tendency to maintain stable ocular alignment. Correction of refractive errors and occlusion are considered as treatment option for amblyopia, and the status of MFS could be changed with long-term follow-up. The purpose of this study is to evaluate whether a Fresnel prism affected the visual acuity, angle of deviation, and sensory status in small-angle esotropia with subnormal stereopsis presenting with MFS features. Patients with small-angle esotropia within 8 prism diopters (PD) on the simultaneous prism and cover test from 2010 to 2019 were reviewed. Patients with subnormal stereopsis defined as more than 100 s of arc (arcsec) and with the central suppression with peripheral fusion were only included. A Fresnel prism was applied to the dominant eye, and the minimum follow-up period after Fresnel prism treatment was 24 months. We assessed patient clinical characteristics, course and response to therapy including visual acuity, angle of deviation, and stereopsis. Twenty patients with a mean age of 5.5 ± 1.4 years were included. The mean duration of Fresnel prism treatment was 15.3 ± 10.3 months. After 50.7 ± 17.2 months of follow-up, VA of the non-dominant eye was changed from 0.26 ± 0.20 logMAR to 0.07 ± 0.17 logMAR (P

Background The efficacies of prism adaptation test (PAT) and monocular occlusion (MO) and their optimal test durations to detect the maximum angles of deviation at near and distance in eyes with intermittent exotropia (IXT) were assessed and compared. Methods We retrospectively reviewed the medical records of 72 patients with IXT. All the patients had undergone the initial strabismus surgery between April 2015 and October 2018 and had been preoperatively tested by both PAT and MO performed on different days for 30 and 60 min. Near and distance deviations after 30 and 60 min of PAT and MO were compared to their baseline measurements obtained immediately after prism wear and before occlusion by alternate prism cover test. The near/distance measurements and required test duration to reveal the maximum deviation angle were also compared between PAT and MO. Results Compared with the baseline, the near deviation by PAT significantly increased after 30 (P P Conclusions In patients with basic and convergence insufficiency types of IXT, a 30-minute PAT appears to be more effective than MO in revealing the maximum angle of deviation before strabismus surgery.

To evaluate the treatment efficacy of the preoperative base-out recovery point as the surgical target angle for acute acquired comitant esotropia.Prospective study. Twenty-two patients with acute acquired comitant esotropia (AACE) underwent strabismus surgery based on the target angle of the preoperative base-out recovery point. The postoperative deviation, positive fusional vergence, and negative fusional vergence were evaluated and compared with those of 23 normal individuals.The mean follow-up period was 18.68 ± 19.48 months. At the last follow-up, 19 (86.4%) of 22 subjects had orthophoria, whereas 3 (13.6%) had minimal esophoria. The postoperative angle of deviation was significantly smaller than the preoperative angle of deviation at near (P 0.001) and distance (P 0.001). Postoperative sensory fusion was significantly better than preoperative fusion at near (P 0.001) and distance (P 0.001). The postoperative stereoacuity improved significantly after the surgery at near (P 0.001) and distance (P 0.001). Compared with the controls, the convergence and divergence amplitudes in the AACE patients were similar at distance (P 0.05) but were still narrower at near (P 0.001).Good alignment and binocular balance were obtained with the surgical target angle of the base-out recovery point in AACE.

In this work, experimental studies were conducted to evaluate the adequacy of the model of the „crane-load” system movement. For research, a laboratory installation (trolley with a load on a flexible suspension), a frequency converter, and encoders were used to measure the position of the trolley and the angle of deviation of the rope with the load from the vertical. Six experiments were performed by varying the duration of the increase and decrease of the frequency of the supply voltage of the trolley drive from 0.5 to 3 s. The increase and decrease of frequency voltage occurred according to a linear law. The data obtained during the experiments were compared with those that correspond to the mathematical model of the „crane-load” system. The mathematical model uses the Kloss equation, and also takes into account the change of frequency of the supply voltage of the drive from the condition of ensuring the overload capacity of the drive. Estimation of deviation of experimental data with results of numerical integration of mathematical model of the movement of the „crane-load” system was carried out based on the coefficient of variation (quantitative analysis) and graphic dependences (qualitative analysis). The obtained results showed the adequacy of the mathematical model of the motion of the „crane-load” system in the form of a system of nonlinear differential equations. Key words: mathematical model, dynamic system, frequency-controlled drive

In the present work, the shading effect of a south building on the aperture of a solar device in the north latitudes is theoretically investigated. A mathematical model to calculate the instantaneous value of shaded area as a function of building horizontal distance, neight, width and the angle of deviation from south direction as well as aperture dimensions has been obtained. The shading factor, which is the ratio between the actual total incident solar radiation and that without shading on the aperture, has been calculated for different geometrical parameters. The annual average shading factor, which may be considered as a reasonable measure of the shading effect is also given in terms of the system dimensionless parameters.

Purpose The correlation between the existence of the preoperative condition of ≥10 prism diopters (PD) in patients with basic type of intermittent exotropia (IXT) and postoperative outcomes was analyzed. Methods The medical records of patients that underwent surgery for IXT were analyzed retrospectively. The analysis was conducted by dividing the patients into a group with change of

We investigated the period of postoperative exodrift during follow-up and clinical factors that affect the rate of exodrift after surgery in the patients with intermittent exotropia (IXT). A retrospective review of medical records of patients with exodrift who underwent bilateral rectus recession for IXT was performed. Exodrift was defined as angle of deviation greater than 10 prism diopters (PD) at distance and near. The median survival period of postoperative exodrift was analyzed using Kaplan Meier survival analysis. The patients were divided into two groups according to the median period of postoperative exodrift (early and late group). The weighted Cox’s proportional hazards regression analysis to investigate the risk factors that affect rate of postoperative exodrift was performed. A total of 108 patients was included. The preoperative angle of deviation at distance and near were 30.3 ± 7.2 PD and 29.5 ± 8.6 PD, respectively. The median survival period of postoperative exodrift was 24 months (range, 6–48 months).The angle of deviation at postoperative day 1 in early and late group were − 3.8 ± 5.5 PD (range, − 16–8 PD) and − 7.7 ± 4.6 PD (range, − 16–4 PD) (p p

To evaluate the passive duction force (PDF) in extraocular muscles (EOMs) in patients with intermittent exotropia (IXT) using a quantitative tension-measuring device. This prospective, case–control study enrolled 25 patients with IXT and 26 age- and sex-matched controls. PDF was measured under general anesthesia as the eyeball was rotated medially or laterally away from the direction of the force being tested. The preferred eye for fixation was determined using a cover–uncover test. The PDF in the IXT and control groups were 60.9 g and 52.1 g, respectively, for the lateral rectus (LR) (p = 0.046) and 53.0 g and 48.8 g for the medial rectus (MR) (p = 0.293). When the eyes were examined separately in the IXT group, the PDF of LR was larger in the nonpreferred eye for fixation than in the control group (p = 0.039), whereas there was no difference in the preferred eye for fixation (p = 0.216). Additionally, the relative PDF of LR in the nonpreferred eye compared to the ipsilateral PDF of MR was positively associated with the duration of manifest deviation (p = 0.042) and the average angle of the near and far deviations (p = 0.023). The PDF in the LR in patients with IXT in the nonpreferred eye for fixation was larger than normal and could increase with the duration of manifest deviation and the angle of deviation. Evaluating the PDF in EOMs could provide information that is useful for managing strabismus and understanding its pathophysiology.

Fatemah T Alshamlan, Halla A Al Abdulhadi, Mofi M Alwalmany, Khalid S Alotaibi Pediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi ArabiaCorrespondence: Fatemah T AlshamlanPediatric Ophthalmology and Strabismus Department, Dhahran Eye Specialist Hospital, P.O. Box 39301, Dhahran 31942, Saudi ArabiaEmail dr_fate82@hotmail.comBackground: Botulinum toxin is known to have a powerful chemodenervation effect, and it is a well-established alternative to incisional surgery for strabismus. This study aims to investigate the efficacy of dose increments of botulinum toxin A (BTA) for the treatment of specific ranges of angle deviation.Methods: This was a prospective study that included patients presenting with esotropia to Dhahran Eye Specialist Hospital between 2016 and 2020, who were managed by a single surgeon. Botulinum toxin was given in different dosages (2.5, 5, 7.5, 10 international units (IU)) according to the size of deviation (11– 19, 20– 29, 30– 39, and ≥ 40 prism diopters (PD)), respectively. A successful outcome was defined as deviation ≤ 10 PD in the last visit (a minimum of 6 months) following a single injection.Results: A total of 56 patients with esotropia were included. The mean pre-treatment angle of deviation was 38.6 ± 2.5 PD. BTA injection in a dose of 2.5 IU for the 11– 19 PD angle of deviation showed the highest rate of successful outcomes (75%). According to the type of esotropia, partially accommodative esotropia showed the best response to the use of dose increments (59%). The incidence of ptosis post-BTA injection was the least (37.5%) with the smallest dose (2.5 IU).Conclusion: BTA usage in dose increments is safe, efficient, and might be more cost-effective with less incidence of BTA associated complications. Different esotropia diagnoses have different clinical responses. However, larger studies are necessary to better predict the outcome of using dose increments.Keywords: esotropia, botulinum toxin A, angle of deviation

Fused deposition modeling (FDM) is an important 3D printing technique which extrudes thermoplastic polymer through a temperature controlled nozzle and deposits layer by layer over a solid platform to create three dimensional products. As each layer of the developed part is comprised of many rasters placed side by side, the part dimensional quality is directly affected by the accuracy of rasters. In the present study, Polylactic acid (PLA) specimens were printed using FDM 3D printer at nozzle temperatures 190 oC, 210 oC, and 230 °C. The part dimensions were measured using micrometer (Mitutoyo, Japan) while raster width and raster to raster air gap was visualized using SEM microscopy and ImageJ software tool. After analysis of the obtained results, it is observed that the minimum deviation in X and Y-dimensions is achieved at higher nozzle temperature; whereas minimum deviation in Z-dimension is obtained at a moderate nozzle temperature. Moreover, the effect of nozzle temperature on Y-dimension and Z-dimension (at shell) is almost similar. A positive deviation in raster width is observed at lower nozzle temperature and vice-versa. The effect of nozzle temperature on the raster to raster air gap was also significant and found maximum at nozzle temperature of 230 °C.

Aim: The aim of this study was to determine the prevalence of vertical tropia following horizontal transposition of both vertical rectus muscles (HToVR) in patients with Duane syndrome or sixth nerve palsy. Methods: This retrospective study included patients with Duane syndrome or sixth nerve palsy who had undergone HToVR muscles. Data collected included: age, gender, diagnosis, laterality, pre-operative angle of deviation, type of surgery and postoperative angle of deviation at one week, three months and six months. Information on the use of botulinum toxin (BT) ipsilateral medial rectus (MR), additional surgery was performed, and the presence of preoperative and postoperative binocular function and any vertical deviation was collected. Results: There were 11 patients, eight patients with a diagnosis of Duane syndrome and three patients with a diagnosis of sixth nerve palsy. The mean age of the patients was 13 ± 14.79 years (range 5–55 years), four were female. The prevalence of postoperative vertical tropia was 54%. The mean vertical deviation for distance, was 7.6^ ± 2.94 (SD) (range 3^–9^). Stereoacuity was present preoperatively in 5 patients and 8 postoperatively. No patient developed diplopia or received further surgery for the vertical tropia. Of the six patients who had intraoperative BT at the time of the HToVR, four developed a vertical deviation. Conclusion: The prevalence of vertical deviation following HToVR muscles was 54% in our series. None of the patients with an induced postoperative vertical deviation reported diplopia or required further surgery for it.

This paper examines the binning of two types of parts with random characteristics, so that a componentwise monotonic evaluation criterion exhibits a minimum deviation to a given target value over all possible realizations. The optimal matching classes are balanced in the sense that the maximum error needs to be the same over all matching classes. This condition allows for a complete solution of the minimum-error matching-class design problem in closed form.

Secondary optical concentrators (focons) designed to operate in a solar concentrator photovoltaic module with Fresnel lenses have been developed and investigated. Both volumetric refractive concentrators and concentrators with internal reflective surfaces in the form of inverted truncated cones and pyramids were created. The use of focons in the design of the photovoltaic module made it possible to achieve a significant increase (more than two times) in the permissible angle of deviation of the optical axis of the concentrator system from the normal position.

The object of research is the stability parameters of the massif of a single-tier dump of soft overburden rocks with a flooded slope when it is formed by a dragline excavator. One of the most problematic areas is determining the safe distance of the dragline excavator from the upper edge of the slope in the conditions of the formation of a single-tier dump of soft overburden rocks, flooded with water.The calculation of the width of the prism of possible shift was carried out using the Rocscience Slide software, which, taking into account the parameters of the slope and the physical and mechanical properties of the rock mass, automatically restores a number of curved sliding surfaces for individual safety factors. The obtained data were processed using the Microsoft Excel software, thanks to which, by the least squares method, graphs of the functions of the possible shift prism width from the height of the tier of a dump of soft overburden rocks and the level of its flooding were constructed.For the conditions of the formation of a single-tier dump of soft rocks of overburden with a height of 40–100 m and a flooding level of 0–30 m, the width of the prism of a possible shift was calculated for sliding surfaces with a safety factor of 1 and 1.2. These values are, respectively, 0–85.9 m and 0–122.6 m within the established calculation limits and depending on the method of constructing curved surfaces. The distance between the points of intersection of the horizontal surface of the tier with curved sliding surfaces with a safety factor of 1 and 1.2 is 16–52.5 m. The dependences of the width of the prism of possible shift (a) on the height of the tier of a dump of soft overburden rocks (Ho) and its level flooding (Hw), taking into account the physical and mechanical properties of the dumped mountain range, including saturated with water. The minimum deviation from the initial value of the coordinates of the points is achieved when setting the second-degree polynomial as the trend line for the function a=f(Hw), and for a=f (Hо) – a straight line.The obtained data for calculating the parameters of the possible shift prism suggest the possibility of forming a single-tier dump of soft overburden rocks with a height of 40–60 m with unloading of rock mass into the worked-out space and 70–100 m with loading the unstable part of the slope with an EK-11/70 excavator-dragline (Novokramatorsk Machine-Building plant, Ukraine)., Объектом исследования являются параметры устойчивости массива одноярусного отвала мягких пород вскрыши с подтопленным откосом при формировании его экскаватором-драглайном. Одним из самых проблемных мест является определение безопасного расстояния установления экскаватора-драглайна от верхней бровки откоса в условиях формирования одноярусного отвала мягких пород вскрыши, подтопленного водой.Расчет ширины призмы возможного обрушения осуществлялся с помощью программного обеспечения Rocscience Slide, которая с учетом параметров откоса и физико-механических свойств горного массива в автоматическом режиме выстраивает ряд криволинейных поверхностей скольжения для отдельных коэффициентов запаса устойчивости. Полученные данные обработаны с помощью программного обеспечения Microsoft Excel, благодаря которому методом наименьших квадратов построены графики функций ширины призмы возможного обрушения от высоты яруса отвала мягких пород вскрыши и уровня его подтопления.Для условий формирования одноярусного отвала мягких пород вскрыши высотой 40–100 м и уровнем подтопления 0–30 м рассчитана ширина призмы возможного обрушения для поверхностей скольжения с коэффициентом запаса устойчивости 1 и 1,2. Эти величины составляют соответственно 0–85,9 м и 0–122,6 м в установленных расчетом пределах и в зависимости от метода построения криволинейных поверхностей. Расстояние между точками пересечения горизонтальной поверхности яруса с криволинейными поверхностями скольжения с коэффициентом запаса устойчивости 1 и 1,2 составляет 16–52,5 м. Установлены зависимости ширины призмы возможного сдвига (а) от высоты яруса отвала мягких пород вскрыши (Hо) и уровня его подтопления (Hw) с учетом физико-механических свойств отсыпанного горного массива, в том числе насыщенного водой. Минимальное отклонение от исходного значения координат точек достигается при установлении в качестве линии тренда полинома второй степени для функции a=f(Hw), а для a=f(Hо) – прямой.Полученные данные расчета параметров призмы возможного обрушения позволяют предположить возможность формирования одноярусного отвала мягких пород вскрыши высотой 40–60 м с разгрузкой горной массы в выработанное пространство и 70–100 м с пригрузкой ею неустойчивой части откоса экскаватором-драглайном ЕШ-11/70 (Новокраматорский машиностроительный завод, Украина)., Об'єктом дослідження є параметри стійкості масиву одноярусного відвалу м’яких порід розкриву з підтопленим укосом при формуванні його екскаватором-драглайном. Одним з найбільш проблемних місць є визначення безпечної відстані встановлення екскаватора-драглайна від верхньої бровки укосу в умовах формування одноярусного відвалу м’яких порід розкриву, підтопленого водою.Розрахунок ширини призми можливого зрушення здійснювався за допомогою програмного забезпечення Rocscience Slide, яка із урахуванням параметрів укосу та фізико-механічних властивостей гірського масиву в автоматичному режимі відбудовує низку криволінійних поверхонь ковзання для окремих коефіцієнтів запасу стійкості. Отримані дані оброблені за допомогою програмного забезпечення Microsoft Excel, завдяки якому методом найменших квадратів побудовані графіки функцій ширини призми можливого зрушення від висоти ярусу відвалу м’яких порід розкриву та рівня його підтоплення.Для умов формування одноярусного відвалу м’яких порід розкриву висотою 40–100 м та рівнем підтоплення 0–30 м розраховано ширину призми можливого зрушення для поверхонь ковзання із коефіцієнтом запасу стійкості 1 та 1,2. Ці значення складають відповідно 0–85,9 м та 0–122,6 м у встановлених розрахунком межах та залежно від методу побудови криволінійних поверхонь. Відстань між точками перетину горизонтальної поверхні ярусу з криволінійними поверхнями ковзання із коефіцієнтом запасу стійкості 1 та 1,2 складає 16–52,5 м. Встановлені залежності ширини призми можливого зрушення (а) від висоти ярусу відвалу м’яких порід розкриву (Hо) та рівня його підтоплення (Hw) із урахуванням фізико-механічних властивостей відсипаного гірського масиву, в тому числі насиченого водою. Мінімальне відхилення від вихідного значення координат точок досягається при встановленні в якості лінії тренду полінома другого ступеня для функції a=f(Hw), а для a=f(Hо) – прямої.Отримані дані розрахунку параметрів призми можливого зрушення дозволяють припустити можливість формування одноярусного відвалу м’яких порід розкриву висотою 40–60 м із розвантаженням гірничої маси у вироблений простір і 70–100 м із привантаженням нею нестійкої частини укосу екскаватором-драглайном ЕК-11/70 (Новокраматорський машинобудівний завод, Україна).

Purpose To evaluate the prevalence of the prism adaptation response in patients with intermittent exotropia (IXT) using the short-term prism adaptation test (PAT) and to assess factors associated with prism adaptation response in IXT patients. Methods A case-controlled retrospective analysis was performed on 113 patients with IXT without prior surgical treatment. Age, sex, visual acuity, refraction, stereoacuity, control scale, type of exotropia, history of occlusion, and presence of accompanying visual symptoms were recorded. Prism alternate cover test (PACT) was performed with fixation targets at 6 m and 1/3 m. All patients underwent short-term PAT wearing prism glasses that offset the exodeviation previously measured by PACT. After 30 minutes, angle deviation was measured, and patients were classified into either an increase group, which had an increase in deviation ≥5 prism diopters after short-term PAT, or a no-change group. Analysis was performed to investigate the clinical factors influencing the increase in exodeviation after short-term PAT. Results Fifty patients (44.2%) showed an increase ≥5 prism diopters during distance or near fixation after short-term PAT compared to the previous PACT: 12 patients (10.6%) showed an increment at distance fixation, and 45 patients (39.8%) showed an increase at near fixation. At distance fixation, the increase-group had a significantly smaller maximum angle measured by PACT. At near distance, age at PAT, maximum distance angle, minimum distance angle, maximum near angle, minimum near angle, angle fluctuation at near, and IXT type showed significant associations with positive short-term PAT response. In the multivariate analysis, older age and smaller maximum near angle were significantly associated with positive short-term PAT response at near fixation. Conclusions Short-term PAT could be helpful in older IXT patients with a small maximum angle of deviation at near fixation to mitigate the vergence aftereffect and show the maximum angle of deviation.

To assess the effects of prism adaptation on the surgical outcomes of individuals with partially accommodative esotropia (PAET). The medical records of 51 patients with PAET who were managed surgically at single referral center were retrospectively reviewed. Patients were divided into two groups according to prism adaptation. Data about sex, age, initial angle of deviation, final angle of deviation, stereoacuity, surgical dosage, and follow-up periods were collected. The main outcome of this study was motor outcomes at 12 months. Eighteen patients had a history of prism adaptation (PA group) and 33 did not (augmented surgery group, AS group). One year after surgery, 12 (66.7%) patients in the PA group and 21 (63.6%) in the AS group achieved an angle of deviation less than 5 PD. The surgical success rate in both groups did not significantly differ (p = 1). After the first prism adaptation test, six patients had an angle of deviation similar to the previous angle; however, 12 patients had larger angle, and consequently required additional prism (prism builder). Two (33.3%) patients who were prism non-builders had deviation less than 5 PD during the final visit. However, among the prism builders, four (57.1%) and five (100%) patients who had prism added once and more than once, respectively, had less than 5 PD deviation during the final visit (p = 0.03). No significant differences were observed in terms of surgical outcomes between both groups. Nonetheless, in PA group, prism builders have better surgical outcomes than non-builders.

Background. Computer-assisted navigation TKA has just been adapted in Indonesia for the last decade. The method is aiming to achieve more precise mechanical alignment in TKA. However, controversies still exist especially in terms of functional outcome and radiological outcome. Method. Fifty elderly patients aged more than 50 years old with severe knee osteoarthritis (Kellgren Lawrence stage III or IV) who scheduled for TKA surgery in the first half of 2019 were consecutively sampled. All patients were measured for objective functional status with Western Ontario Mac Master University Index (WOMAC) and Oxford Knee Score (OKS). Weight-bearing, long-leg follow-up radiographs of both lower limbs were taken, and coronal tibiofemoral angle (CTFA), coronal femoral component angle (CFCA) and coronal tibial component angle (CTCA) were measured. Results. Group of computer-assisted navigation TKA surgery was found to have significantly lower WOMAC score (p

Heba M Shafik, Mohamed Ashraf Eldesouky, Dina Tadros Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Heba M ShafikTanta University Hospital, El-Geish Street, Tanta, EgyptTel +00201227440829Fax +0020403274005Email drhebash81@gmail.comPurpose: To evaluate using the resected medial rectus muscle for elongation of the lateral rectus tendon in monocular surgery for large-angle sensory exotropia.Patients and Methods: A prospective case series was carried out in Tanta University hospital from January 2017 to June 2018 including 16 patients with large-angle sensory exotropia ≥ 50PD. The near and distance angles of exotropia were measured; any restrictions in adduction or abduction were recorded and scaled from − 4 to 0. Resection of the medial rectus muscle was done first; the resected segment was attached to the lateral rectus muscle after dissection by mattress sutures, and the muscle was recessed after elongation according to the preoperative distance angles. Successful motor alignment was considered if the angle measurement was within 10 PD of orthotropia at distance after 6 months. The stability of the alignment, any motility restrictions, and patient satisfaction were recorded at each follow-up visit until the 6th month.Results: The mean age of the study patients was 30.68± 13.30 years. The best-corrected visual acuity of the exotropic eyes by logMAR was 1.2± 0.3; the mean of the preoperative distance angle of deviation was − 72.19 ± 14.26 PD. The mean preoperative adduction and abduction restrictions were − 1.19 ± 1.52 and − 1.13 ± 1.09, respectively. There was significant improvement in the distance angle of deviation at the last follow-up after 6 months (p=0.001*). Also, there was improvement in both adduction and abduction restriction from the first to last follow-up. Thirteen patients (81.2%) were satisfied at the 6-month follow-up.Conclusion: Elongation of the lateral rectus muscle by an autograft from the resected medial rectus muscle is an easy, effective procedure for large-angle sensory exotropia. Patients achieve good postoperative alignment with minimal restriction of ocular motility.Keywords: sensory exotropia, autograft, lateral rectus elongation

We evaluated surgical outcomes of bilateral rectus (BLR) recession in patients with intermittent exotropia who underwent diagnostic monocular occlusion. Records of patients with intermittent exotropia who were preoperatively examined one-hour monocular occlusion and underwent BLR recession were reviewed retrospectively. Patients were classified into two groups based on change in exodeviation angle: responders (≥5 change in prism diopters [PD] after occlusion) or non-responders (

The article discusses a simple method to find the angle of minimum deviation of a general prism, not necessarily equilateral or isosceles. The method uses a single measurement and requires a compass, ruler, some pins, and no additional material. It is precise and accurate. We present the method first and then the justification.

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.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.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″).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.Das Ziel dieser Studie war es, die operativen Ergebnisse, den Dosiseffekt sowie den Grad an erreichter Binokularität bei Patienten nach Operation einer konsekutiven Exotropie zu untersuchen.21 Patienten wurden in die Studie eingeschlossen. Wir analysierten den prä- und postoperativen Schielwinkel, gemessen mit dem alternierenden Prismen-Cover-Test, den chirurgischen Dosiseffekt (DE) sowie die Stereofunktion.Alle Patienten waren aufgrund einer Esotropie im Kindesalter bereits operiert. Die Operation der konsekutiven Exotropie wurde im Mittel in einem Alter von 35,92 ± 18,26 Jahren durchgeführt. Bei 19 Patienten wurde an mindestens einem bereits voroperierten Muskel operiert. Das mittlere Intervall zur letzten Operation lag bei 25,67 ± 16,14 Prismendioptrien (PD). Der mittlere Schielwinkel lag bei − 33,43 ± 12,75 PD präoperativ, + 0,76 ± 7,91 PD 1 Woche postoperativ und − 7,24 ± 12,14 PD nach 3 Monaten. Der mittlere Dosiseffekt lag bei 3,58 ± 1,53 mm/PD 1 Woche postoperativ und bei 2,70 ± 1,78 mm/PD nach 3 Monaten. Postoperativ waren 62% zumindest Bagolini-positiv, 33% der Patienten waren entweder TNO- oder Titmus- und sogar 24% Lang-I-positiv (550″).Die Strabismuschirurgie der konsekutiven Exotropie erreicht in einer Vielzahl an Patienten ein gewisses Maß an Binokularität auch im Erwachsenenalter und sollte daher in Erwägung gezogen werden. Der Dosiseffekt ist vergleichbar mit der Chirurgie anderer Exotropieformen.

Aiming at the problem that the special-shaped sheet metal part with 3D top edge lines is difficult to form directly, this paper proposed a method of transforming the 3D top edge lines into the planar top edge lines by filling the surface to realize its CNC incremental forming. Firstly, the optimal datum plane for the surface filling was determined by using the multi-objective decision making method according to the formability, forming depth, filling area, and other factors. Then, the vacant area between the datum plane and the sheet part was filled. Finally, the forming toolpath for the forming process was generated using the filled model. The forming quality of the formed sheet part was analyzed by using the numerical simulation, and the sheet metal parts was formed by the forming experiment. The results show that the maximum and minimum deviation in the Z-axis direction between the experimental part contour and the designed model contour in the Z-axis direction are 0.4672 mm and 0.0096 mm, respectively. While the maximum and minimum thickness are 0.698 mm and 0.533 mm, respectively.

The purpose of this study was to investigate if the angle of deviation with Polarized glasses is effective for measuring maximal angles in patients with intermittent exotropia (IXT).Prospective cross-sectional study.This study was conducted on patients with10 prism diopters (PD) of basic-type IXT at distance and near. Three consecutive, different methods for measurement of the angle of deviation were used: alternate prism cover test (ACT), ACT with Polarized glasses (Polaroid test), and ACT after 1 hour of monocular occlusion (occlusion test). Comparison of the 3 methods of measurement was conducted using the Friedman repeated ANOVA and Wilcoxon signed rank test.A total of 60 patients were included in this study. Thirty (50%) patients were male. Mean age was 8.7 ± 5.1 years (range, 4-37 years) and measurements by ACT at distance and near were 25.2 ± 8.0 PD and 25.4 ± 8.2 PD, respectively. Angles of Polaroid and occlusion tests (29.0 ± 8.6 PD vs 30.6 ± 8.1 PD) were significantly increased compared to that of ACT at distance (P.01), and there was no significant change between angles of Polaroid and occlusion tests at distance (P = .06). However, there was no significant change between angles of ACT and Polaroid tests (25.4 ± 8.2 PD vs 26.9 ± 8.1 PD) at near (P = .07).The angle of deviation with Polarized glasses at distance increased and was comparable to that after the monocular occlusion test. The angle of exodeviation with Polarized glasses may be an easy, simple and effective alternative to measurement of maximum angle of deviation in IXT.

Objective To evaluate the accuracy and safety of a combined 3D printed guide template (combined template) to assist iliosacral (IS) screw placement for sacral fracture and dislocation. Methods A total of 37 patients, 24 men and 13 women, age from 22 to 68 years old, diagnosed with a sacral fracture and dislocation were involved in this study for retrospective analysis from January 2016 to February 2018. There were 19 patients in the template group (42 screws) and 18 patients in the conventional group (31 screws). In the combined template group, IS screw placement was assisted by a combined 3D printed template; in the conventional group, the IS screws were placed freehand under fluoroscopy. The accuracy of the IS screw placement was evaluated by comparing the screw angle and the location of the screw entry point between the actual and the simulated screw in the combined template group. The safety of the IS screw placement was evaluated by comparing the quality of the reduction, the grading of the screws, the operation time, and radiation exposure times between groups. Results A total of 73 pedicle screws were placed in 37 patients: 42 screws (30 S1, 12 S2) in the combined template group and 31 screws (23 S1, 8 S2) in the conventional group. In the conventional group, 1 patient developed symptoms of L5 nerve stimulation. In the combined template group, the average operative time of each screw was 25.01 ± 2.90 min, with average radiation exposure times of 12.05 ± 4.00. In the conventional group, the average operative time of each screw was 46.24 ± 9.59 min, with an average radiation exposure time of 56.10 ± 6.75. There were significant differences in operation and radiation exposure times between groups. The rate of screw perforation was lower in the combined template group (2 of 42 screws, 0 at grade III and 2 at grade II) than in the conventional group (5 of 38 screws, 2 at grade III and 3 at grade III). In the combined template group, the mean distance between the entry points of the actual and simulated screws was 1.4 ± 0.9 mm, with a mean angle of deviation of 2.1° ± 1.6°. All patients were followed up once every 3 months and were followed for 3 to 12 months. Conclusion Using the combined template to assist with the insertion of IS screws delivered good accuracy, less fluoroscopy and shorter operation time, and avoided neurovascular injury as a result of screw malposition.

Summary Introduction Sensory exotropia is often due to profound amblyopia. Surgery essentially aims to improve aesthetic appearance and quality of life. Our goal was to discuss clinical features of sensory exotropia as well as surgical indications and outcomes. Methods Medical records of 43 patients who underwent sensory exotropia surgery were retrospectively reviewed. Each patient had an ophthalmological examination and a complete sensorimotor assessment. All surgeries were performed by the same surgeon. We studied the influence of certain prognostic factors on motility outcomes, such as age of onset of strabismus, gender, delay of surgical management, degree of amblyopia, angle of deviation, and amount of recession/resection. Results The mean follow-up was 2.3 years. All of our patients had severe amblyopia. An abnormal retinal correspondence with no fusion or stereopsis was noted in all subjects. The mean angle of deviation was 44.5 PD ± 12.4 SD preoperatively. The alignment success rate after a single procedure was 65.1%. Eight patients developed recurrent exotropia and were reoperated, with a final alignment success rate of 74.4%. Conclusions Sensory exotropia is characterized by a large angle of deviation and an altered sensory status. The overall goal of surgery is to improve the patient's aesthetics and quality of life by treating the maximum angle of deviation. Surgical outcomes are often satisfactory for the patients, but certain complications may occur, such as diplopia, enopthalmos, and recurrences.

This study was conducted to examine the relationship between service hit and proprioception in adolescent female and male volleyball players. 48 volleyball players, 24 men and 24 women between the ages of 12-16, who are actively playing volleyball and able to serve tennis at the Anakent and DSI sports clubs in Samsun participated in the study. Demographic information form developed by the researcher was filled by the participants to the questions posed. Angle repeat test was used for the measurement of proprioception at the shoulder joint angle. Active joint motion sensation was measured during measurement. Baseline 1 ° sensitive digital goniometer was used in the measurements. IBM SPSS Statistics 21 package program was used to analyze the data. Normality testing of data on service hit and deviation angle it was determined that the data made using the Shapiro-Wilk test did not show normal distribution (p≤0.001). According to the findings obtained from the study, no relation was determined between the angle of deviation and the number of hits in male and female volleyball players (p>0.05). Although the average of deviation angle of women (2.99 degrees) is better than men (4.27 degrees), it is seen that women (3.38 points) have a lower hit rate than men (3.75 points). According to the results of the research, the service studies performed by men both in terms of physical strength and training were associated with having higher service hit rate than women. In the literature, the number of studies examining the relationship between proprioceptive sensation and hit rate in the shoulder joint has been seen as low. Studies have often been determined as proprioception studies, either to be done after or to prevent injury. Less studies have shown that more studies are needed in this area. Physical education teachers and coaches who work in the field do more work on this, children and adolescent athletes are recommended to do exercises to improve proprioceptive sensation.

Table S1. Summarized archaeomagnetic determinations of the studied collections. D – magnetic declination after sun compass correction; I – magnetic declination; Fa – archaeointensity value obtained with the corresponding standard deviation (σ) in a temperature interval Tmin – Tmax using NPI points; NRM fraction (f); gap factor (g); quality factor (q); maximum angle of deviation (MAD) are also given. In the sample name, the small letters indicate the specimens used for AI determination whereas each sample direction is calculated as an average of two or three specimen' directions after the corresponding cleaning (thermal or AF). Specimens treated in Rennes laboratory are marked in grey.

The mathematical expressions, specifying the estimation of the capabilities of remote sensing satellites with opto-electronic imaging equipment for observing the Earth’s surface with the necessary (predetermined) spatial resolution of the space imaging materials when deflecting the optical axis of on-board information complex, are obtained and substantiated in the article. The validity of the obtained expressions is proved by comparing the results of the solution of the direct and inverse problems of determining the spatial resolution of the space imaging materials when the optical axis of the on-board information complex of remote sensing satellites is deflected. Taking into account the deterioration of spatial resolution depending on the angle of deviation of the on-board information system of the satellites and the curvature of the Earth provides increasing the accuracy in determining the field of regard of satellites when modeling the state and changes in the space situation, as well as assessing their surface capabilities for space imaging. The capabilities of remote sensing satellites with opto-electronic equipment have been evaluated and it has been proved that the space imagery they receive cannot be applied to detect and identify (to the kind, class, type) objects of observation within the entire field of regard of imaging equipment, provided that the claimed spatial resolution of the space imaging materials. Prospects for further research are the refinement solution of practical problems in planning the use of on-board resource of remote sensing satellites, the improvement of algorithms for taking into account the possible observation of domestic territory (objects) with the help of foreign spacecraft’s and improving the methods of estimation of the remote sensing satellites with radar equipment.

The study focuses on developing a computational model on low-velocity impact which includes the study of different composite materials, and the materials selected include thermosets such as carbon–epoxy, glass–epoxy and thermoplastic such as Twintex material. The above materials were selected because of their high impact resistance properties as well as energy absorption capacity. Furthermore, the damage tolerance of these materials is higher when compared to the polycarbonate material which is presently used. The analysis was carried out using ABAQUS–CAE software where the study was extended to two different types of impact, i.e., linear and oblique, with their damage evolution and analytical validation. The study further focuses on energy absorption capacity, depth of penetration and strain energy absorption by the material under linear and oblique impacts. The analysis revealed the fact that the material Twintex is superior to carbon–epoxy and glass–epoxy with regard to the stress developed. The analysis was carried out by incorporating the Hashin damage criteria also. It was observed that the Twintex material offered more resistance to the depth of penetration in both types of impact. The computational results were compared with analytical results, and they were found to be very close with a minimum deviation.

Objective To evaluate the surgical outcome of unilateral medial rectus resection with small advancement for recurrent exotropia, ≤30 prism diopters (PD), and verify new attachment site anatomically using anterior segment optical coherence tomography (ASOCT). Method This study is a retrospective chart review of patients who underwent 1.0 mm advancement of unilateral resected medial rectus from original medial rectus (OMR) insertion for recurrent exotropia since 2014. The age at operation, sex, preoperative angle of deviation, near stereopsis, and suppression were evaluated. Success was defined as ≤5 PD of esodeviation or ≤10 PD of exodeviation at the final visit. Preoperative scleral thickness was measured using ASOCT, 1.0 and 0.5 mm anterior to OMR insertion, and at the insertion. Results A total of 76 patients, including 30 males (40.2%), were reviewed retrospectively. Continuous values were presented as mean ± standard deviation. Age at operation was 11.6 ± 6.6 years. The preoperative deviation was 20.9 ± 3.6 PD, and the amount of resected unilateral medial rectus was 4.5 ± 0.6 mm. The minimum required follow-up period after operation was 12 months after surgery. The postoperative follow-up period was 21.3 ± 8.0 months. A total of 65 patients (87.8%) showed successful outcome at the final visit. Preoperative scleral thickness at 1.0 and 0.5 mm anterior to OMR insertion site, and at OMR insertion site were 0.52 ± 0.05, 0.52 ± 0.06, and 0.43 ± 0.04 mm, respectively. Scleral thickness at OMR insertion site was significantly less compared with 1.0 and 0.5 mm from the OMR insertion site (p = 0.03). Conclusion The scleral thickness 1.0–0.5 mm anterior to OMR insertion site was thicker that than at the OMR insertion site. The new technique of medial rectus resection with small advancement may be safer and more effective than conventional technique.

Purpose: To establish whether clinical factors were correlated with deviation control in intermittent exotropia. Methods: This retrospective study included 54 patients with intermittent exotropia. The patient's sex, family history, age at first admission, best corrected visual acuity, refractive errors after cycloplegia, angles of ocular deviation at near and distance, and near, distance, and total deviation control were evaluated. Ocular deviation controls were determined according to the Mayo Clinic's office-based scale. Correlation analysis was performed between the deviation control and the determined clinical factors. Results: Spearman correlation analyses revealed a mild correlation between age with total exotropia control score and age with the control of near exotropia control score ( r = 0.320, P = .018 and r = 0.339, P = .012, respectively). The angle of deviation at near showed a significant moderate correlation between total exotropia control score and near exotropia control score ( r = 0.523, P < .001 and r = 0.780, P < .001, respectively). The deviation angle at distance showed a mild correlation with distance exotropia control score and total exotropia control score ( r = 0.423, P = .001 and r = 0.288, P = .034, respectively). The angle of deviation at distance showed a mild correlation with the angle of deviation at near ( r = 0.359, P = .008). The deviation angle at distance was established as an independent factor for predicting total exotropia score ( P = .037, P = .015, respectively). Conclusions: The high deviation angle correlates positively with poor deviation control. The distance deviation angle is an independent predictor of total deviation control for the first time in the literature. [ J Pediatr Ophthalmol Strabismus . 2022;59(1):53–59.]

This paper proposes a feed rate control strategy for a novel volumetric micro-feeder, which can accomplish low-dose feeding of pharmaceutical raw materials with significantly different powder properties. The developed feed-forward control strategy enables a constant feed rate with a minimum deviation from the set-point, even for materials that are typically difficult to accurately feed (e.g., due to high cohesion or low density) using conventional continuous feeders. Density variations observed during the feeding process were characterized via a displacement feed factor profile for each powder. The characterized effective displacement density profile was applied in the micro-feeder system to proactively control the feed rate by manipulating the powder displacement rate (i.e., computing the feed rate from the powder displacement rate). Based on the displacement feed factor profile, the feed rate can be predicted during the feeding process and at any feed rate set-point. Three pharmaceutically relevant materials were used for the micro-feeder evaluation: di-calcium phosphate (large-particle system, high density), croscarmellose sodium (small-particle system, medium density), and barium sulfate (very small-particle

To evaluate the outcome in participants who underwent surgery for esophoria following one of three different methods of preoperative prism adaptation test (PAT).This prospective, multicentre study was carried out at five eye departments from 2012 to 2019. 116 participants were included and allocated to three groups as per investigator choice: Group 1 (n = 55) had a short prism adaptation period ranging from 1 to 5 hours during their visit at the clinic. Group 2 (n = 36) underwent partial prism correction for at least 4 weeks before surgery. Group 3 (n = 25) underwent full prism correction for at least 4 weeks before surgery. Motoric success was determined by postoperative angle of deviation (AOD), and sensoric success was evaluated with Lang and Bagolini striated lens test.A significant increase (p 0.001) in AOD after PAT was observed in all groups, with no significant difference between groups (distance: p = 0.22; near: p = 0.31). Motoric and sensoric success was comparable between groups 3 months (p = 0.52; p = 0.55) and 1 year (p = 0.53; p = 0.29) after surgery. Prolonged prism adaptation (n = 24) for more than 365 days was not associated with better results.Our study indicates that the postoperative result is independent from the duration and amount (partial or full correction) of prism adaptation before surgery at least up to one year of follow-up. Prolonged prism adaptation (365 days) before surgery does not improve the results.

Recent developments in time-resolved Particle Tracking Velocimetry (4D-PTV) consistently improved tracking accuracy and robustness. We propose a novel technique named ”Lagrangian coherent predictor” to estimate particle positions within the 4D-PTV algorithm. We add spatial and temporal coherency information of neighbour particles to predict a single trajectory using Lagrangian Coherent Structures (LCS). We found that even a weak signal from coherent neighbour motions improves particle prediction accuracy in complex flow regions. We applied Finite Time Lyapunov Exponent (FTLE) to quantify local boundaries (i.e. ridges) of coherent motions. Synthetic analysis of the wake behind a smooth cylinder at Reynolds number equal to 3900 showed enhanced estimation compared with the recent predictor functions employed in 4D-PTV. Results of the experimental study of the same flow configuration are reported. We compared predicted positions with the optimised final positions of Shake The Box (STB). It was found that the Lagrangian coherent predictor succeeded in estimating particle positions with minimum deviation to the optimised positions.

Objective To compare the angle of deviation measured from Photo-Hirschberg testing and Krimsky testing, with that from an alternate prism cover test (APCT) in strabismus patients. Methods A cross-sectional study was conducted in Songklanagarind Hospital, Thailand. Thirty-three strabismus patients were photographed for analysis by Photo-Hirschberg testing using computer software. The corneal light reflex displacement, converted into prism diopter (PD), was compared to the angle of deviation measured with APCT. Twenty-eight strabismus patients were tested with the Krimsky test. Data were analyzed using Pearson correlation and paired t-tests. The study excluded 4 intermittent exotropia cases, 1 intermittent esotropia case and 2 which cases missing data for krimsky test. Results The mean±SD of the deviation angle, measured by APCT with a fixation target at 30 cm and 6 m; were 48.09±16.34PD and 47.82±15.73 PD, respectively. At 1 m, the difference in the angle of deviation measured from APCT and the Photo-Hirschberg test within 10 PD were 58.8% and 63.6%, for ET and XT, respectively. The difference in the angle of deviation measured from APCT and Krimsky tests within 10 PD in ET and XT were 86.7% and 80.0%, respectively. At 4 m, the difference in angle of deviation measured from APCT and Photo-Hirschberg tests within 10 PD in ET and XT were 58.8% and 54.5%, respectively; whereas, the difference in the angle of deviation measured from APCT and Krimsky tests within 10 PD in ET and XT were 80.0% and 70.0%, respectively. Conclusion The reliability of Krimsky test was better than Photo-Hirschberg test for measuring an angle of deviation.

We introduce a prototype “machine tool analyzer” (MTA), consisting of a nest of five displacement sensors and a dual-ball system with two centering structures, designed to identify 13 position-independent geometric errors (PIGEs) in five-axis machine tools. The 13 PIGEs include three squareness errors in the three linear axes, two squareness errors and two offset errors in the rotary/tilting axis, and two squareness errors in the spindle axis. The MTA completes four circular paths, during which an identification algorithm identifies thirteen possible PIGEs and set-up errors. The MTA was applied to a commercial five-axis machine tool with a swivel head/rotary table and verified experimentally. Cost-effective measurements were achieved using a single set-up of the nest and associated system. In addition, a circular test using a double ball-bar was used to test the volumetric accuracy of the five-axis machine tool and verify the identified PIGEs. The maximum deviation, minimum deviation, and PV values in the circular test were 109, 55, and 55 μm, respectively, without compensation for errors imparted by the PIGEs, and 38, 5, and 33 μm, respectively, with compensation. This demonstrated the validity of the proposed method.

Nasal cavities in their primitive stage communicate with the oral cavity until the 8th week of intrauterine life where the posterior palate initiates its development. Hence, starting from the initial growth phases, a significant connection lays between the nasal structures and the maxillary bone and witnessing key functional roles, among which the respiration. Proper nasal breathing has been proven to be a crucial factor for the maturity of the craniofacial complex, and obstruction of the respiratory airway due to nasal septum deviation can generate clinically significant reduction of the nasal airflow. This situation will imply irreversible repercussions that hinders the harmonious development of the craniofacial complex. In order to understand such potential impacts of septal deviation, our first objective was to materialize the relation between septum deviation, and both nasal cavity and maxillary structures. For the second objective, we used Procrustes analysis to assess the shape variation of these two anatomical regions, the bivariate plots of Principal Components to evaluate their shape space, and a two-block Partial Least Square (PLS) to explore their covariation. We analysed, in this cross-sectional study, 62 posteroanterior cephalometric radiographs of adult subjects from both sexes (23 males, 39 females; mean age 25.3 years) collected from the database of the Department of Orthodontics at Lebanese University. Landmarks were plotted and variables were calculated and divided into nasal septum, nasal cavity and maxillary ones. The sample was further divided into two groups based on septal deviation severity (a septal deviation is considered minor if

CLINICAL RELEVANCE Acute acquired comitant esotropia (AACE) is characterised by the acute onset of diplopia which affects work and life.Background: To describe the clinical characteristics and discuss the aetiology of acute acquired comitant esotropia.Methods: The medical records of 51 patients with AACE were retrospectively analysed, and their age, occupation, daily average time spent on near work, angle of deviation, refractive error and aetiology were analysed.Results: The age at onset of AACE was eight to 55 years. Thirty-nine patients were aged 12 to 36 years (76.5%), and 42 patients (82.4%) were myopic. The angle of deviation was 20Δ (12Δ to 35Δ) during near fixation and 25Δ (18Δ to 40Δ) during distance fixation. The deviation during distance fixation was larger than that during near fixation, the difference being statistically significant (p 0.05). Among the 51 patients, three had intracranial diseases. Diplopia resolved in 47 cases following treatment. The angle of deviation post-treatment was 0Δ (0Δ to 5Δ) during near and 0Δ (0Δ to 3Δ) during distance fixation.Conclusion: AACE occurs mostly in myopic older children and adults. The onset of esotropia is related to long-term near work. AACE patients mostly present an angle of deviation that is larger during distance than near fixation. Intracranial disease is an infrequent but important cause of AACE that needs to be excluded in all cases.

Purpose: Here we aimed to describe seven pediatric patients with cyclic strabismus and report the outcome of their surgical treatment.Methods: Seven children with acquired esotropia manifesting in a 48-h cycle were included in the study. Four of them were boys, and three of them were girls. All cases had a large angle of deviation and associated suppression on the esotropic day and small angle of deviation with fusion on the other day. A complete ocular motility examination was performed for seven consecutive days. For all cases, we planned strabismus surgery according to the amount of deviation on the strabismic day. Postoperatively, the deviation angles were recorded at the first week, first month, and third month. Later, the patients were examined at 3-month intervals.Results: The mean age at presentation was 4.42 ± 3.69 years (1-12 years). The mean angle of esotropia at near fixation preoperatively was 36.4 ± 14.9 pd (prism dioptre) (20-60 pd) on the esotropic day. The mean angle of esotropia on the esotropic day at distance fixation was 32.1 ± 6.9 pd (20-40 pd). The mean follow-up period was 18.4 ± 5.5 months (12-25 months). The mean duration of esotropia before surgery was 11.1 ± 9.4 months (3-29 months). Following surgery, orthophoria within 10 pd was achieved and maintained in all cases.Conclusion: When treating children with cyclic strabismus, the best surgical results can be achieved when surgery is planned according to the amount of deviation on the strabismic day.

To investigate clinical characteristics of adults with acute acquired comitant esotropia and to evaluate the muscle recession amount needed to achieve a favorable outcome after performing medial rectus muscle recession. Retrospective study. Patients diagnosed with acute acquired comitant esotropia, who underwent medial rectus muscle recession with adjustable suture between 2008 and 2016 were included. Surgical outcomes were classified into motor and sensory. The motor outcomes were evaluated at the 1-year postoperative visit and divided into success (orthotropia or esodeviation ≤ 8 PD) and failure (esodeviation > 8 PD). The successful sensory outcomes were defined as elimination of diplopia in primary gaze. Factors including age, sex, refractive error, deviation angle, and surgical amount were compared between groups. Sixteen subjects were included whose mean (± SD) age at the initial visit was 27.5 ± 11.0 years. Mean preoperative maximum angle of deviation was 27.9 ± 9.3 PD at distance and 28.6 ± 12.0 PD at near. Mean refractive error was -2.55 ± 2.92 D. Twelve of 16 subjects (75%) had successful motor and sensory outcomes. Age, sex, refractive error and deviation angle were not different between the two groups. Both success and failure groups required a greater amount of medial rectus muscle recession than those indicated by the Parks’ surgical table, with a 40.6 ± 25.8 % augmentation in the success and 7.9 ± 6.9 % in the failure group (P = .028). To achieve better surgical outcomes in adults with acute acquired comitant esotropia, targeting postoperative orthotropia by increasing the amount of medial rectus muscle recession is recommended.

Ways of determining Langmuir constants are evaluated to improve the accuracy of calculating the parameters of hydrate processes. An indirect approach is used in the evaluation that consists of calculating the hydrate number using the Langmuir constants and comparing it to known values. The criterion of evaluation is the minimum deviation between these values. The selection of the best way of calculating the Langmuir constants is validated.

Background/AimsTo compare the long-term surgical outcomes between unilateral lateral rectus recession-medial rectus resection (RR) and lateral rectus recession-medial rectus plication (RP) in children with intermittent exotropia.MethodsChildren who underwent RR or RP for intermittent exotropia between January 2008 and July 2016, with a minimum follow-up period of 2 years were retrospectively reviewed. Postoperative angle of deviations and clinical factors including sex, age, refractive errors, preoperative angle of deviation, types of exotropia and stereopsis were investigated. Based on the angle of deviation at year 2, surgical outcomes were classified into two groups as follows: success (esodeviation ≤5 prism dioptres (PD) to exodeviation ≤10 PD) and failure (overcorrection (esodeviation >5 PD) and undercorrection or recurrence (exodeviation >10 PD)).ResultsOf the 186 patients, 114 underwent RR and 72 underwent RP. The angle of exodeviation steadily increased over time in both groups after surgery. The durations of exodrift were longer in the RP group than in the RR group. The surgical success at postoperative year 2 was 55.3% in the RR group and 27.8% in the RP group (pConclusionsIn children with intermittent exotropia, RR group presented better surgical outcomes than RP group. The amount of initial overcorrection was important to achieve favourable outcomes in children with intermittent exotropia.

Purpose: To evaluate strabismus surgery with intraoperative adjustment of sutures under topical anesthesia in children. Methods: Nineteen children with horizontal deviation underwent a one-stage surgical technique performed under topical anesthesia. Surgery consisted of unilateral or bilateral recession and/or resection of horizontal muscles or the medial or lateral rectus muscles, with intraoperative adjustment of sutures based on alternate prism cover test. Follow-up was done at 1 day and 1, 3, and 6 months postoperatively. Results: Mean age at surgery was 12.68 ± 2.50 years (range: 8 to 16 years). Mean preoperative angle of deviation was 24.21 ± 11.20 prism diopters (PD) (range: −50 to +30 PD) at distance. Mean postoperative angle of deviation at 6 months was 4.11 ± 2.87 PD (range: −10 to +10 PD) at distance. In esotropic patients, the average angle of deviation decreased from +23.80 ± 5.89 PD preoperatively to +4.80 ± 3.35 PD at 6 months, whereas in exotropic patients it decreased from −24.36 ± 12.76 to −3.86 ± 2.77 PD. Seventeen of 19 patients (89%) remained comfortable during surgery, whereas 2 needed an intravenous injection of propofol. The success rate, defined by a postoperative residual angle of deviation of ±8 PD or less, was 89% at 6 months. Conclusions: Strabismus surgery with intraoperative suture adjustment under topical anesthesia in children is a tolerable procedure with encouraging outcomes, representing an alternative to general anesthesia in well-selected children. Clinical evaluation of children and parents is fundamental to predict a likely poor collaboration of the child during surgery, which, if present, would require surgery under general anesthesia. [ J Pediatr Ophthalmol Strabismus . 2019;56(3):173–177.]