139 results on '"squint surgery"'
Search Results
2. Recent Advances in Inferior Oblique Strabismus Surgeries
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Jethani, Jitendra, Nishanth, Shruti, and Jethani, Jitendra, editor
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- 2023
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3. Fixation stability after surgical treatment of strabismus and biofeedback fixation training in amblyopic eyes
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Otto Alexander Maneschg, Mirella Telles Salgueiro Barboni, Zoltán Zsolt Nagy, and János Németh
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Strabismus ,Amblyopia ,Microperimetry ,Biofeedback fixation training ,Squint surgery ,Ophthalmology ,RE1-994 - Abstract
Abstract Background Visual fixation may be affected in amblyopic patients and, moreover, its stability may be associated with the effects of amblyopic treatments on visual performance in patients with strabismus. Therefore, fixation stability is a relevant biomarker that might predict the recurrence of amblyopia after a therapeutic intervention. Microperimetric biofeedback fixation training (BFT) can stabilize visual fixation in adult patients with central vision loss. It was the purpose of the present study to evaluate the effects of BFT on fixation stability in adult amblyopic patients after surgical intervention to treat strabismus. Methods Participants were 12 patients with strabismus (mean age = 29.6 ± 8.5 years; 6 females) and 12 healthy volunteers (mean age = 23.8 ± 1.5 years; 9 females). The protocol included ophthalmological and microperimetric follow-ups to measure fixation stability and macular sensitivity. BFT was applied monocularly to four amblyopic eyes either on the spontaneous preferential retinal locus or to a fixation area closer to the anatomical fovea after surgical treatment of strabismus. Results Baseline measurements showed significantly altered microperimetric average threshold in amblyopic eyes compared to fellow eyes (p = 0.024) and compared to control eyes (p
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- 2021
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4. A Divergent Sequela of Scleral Buckle Removal.
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Tan L, Chew Lee Min F, Kamarudin ZB, and Mohd Khialdin S
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Scleral buckle (SB) removal is done for a variety of reasons following treatment of rhegmatogenous retinal detachments (RRD), such as buckle exposure, migration, and infection. The most worrying complication of SB removal is retinal redetachment. We report a unique case of a patient developing strabismus about one month after scleral buckle removal for anterior migration and exposure of the scleral buckle. We also share a successful strabismus surgery which had a main aim of relieving diplopia in the patient's primary gaze., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Tan et al.)
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- 2024
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5. Fixation stability after surgical treatment of strabismus and biofeedback fixation training in amblyopic eyes.
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Maneschg, Otto Alexander, Barboni, Mirella Telles Salgueiro, Nagy, Zoltán Zsolt, and Németh, János
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BIOFEEDBACK training ,STRABISMUS ,VISION disorders ,VISUAL training ,ADULTS ,BIOMARKERS ,STRABISMUS surgery ,EYE movements ,AMBLYOPIA ,PHYSIOLOGICAL control systems ,VISUAL acuity - Abstract
Background: Visual fixation may be affected in amblyopic patients and, moreover, its stability may be associated with the effects of amblyopic treatments on visual performance in patients with strabismus. Therefore, fixation stability is a relevant biomarker that might predict the recurrence of amblyopia after a therapeutic intervention. Microperimetric biofeedback fixation training (BFT) can stabilize visual fixation in adult patients with central vision loss. It was the purpose of the present study to evaluate the effects of BFT on fixation stability in adult amblyopic patients after surgical intervention to treat strabismus.Methods: Participants were 12 patients with strabismus (mean age = 29.6 ± 8.5 years; 6 females) and 12 healthy volunteers (mean age = 23.8 ± 1.5 years; 9 females). The protocol included ophthalmological and microperimetric follow-ups to measure fixation stability and macular sensitivity. BFT was applied monocularly to four amblyopic eyes either on the spontaneous preferential retinal locus or to a fixation area closer to the anatomical fovea after surgical treatment of strabismus.Results: Baseline measurements showed significantly altered microperimetric average threshold in amblyopic eyes compared to fellow eyes (p = 0.024) and compared to control eyes (p < 0.001). Fixation was unstable in amblyopic eyes compared to control eyes (p < 0.001). Fixation stability did not significantly change after surgical alignment of strabismus (p = 0.805). BFT applied to operated eyes resulted in a more stable fixation with improvements of about 50% after three months of training.Conclusions: Fixation stability improvements following BFT highlight its potential use in adult amblyopic eyes after the surgical alignment of the strabismus. Future investigations may also consider applying this method in combination with standard treatments to improve vision in amblyopic patients. [ABSTRACT FROM AUTHOR]- Published
- 2021
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6. Quantification of Global Ocular Motility Impairment in Graves' Orbitopathy by Measuring Eye Muscle Ductions.
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Campi, Irene, Currò, Nicola, Vannucchi, Guia, Covelli, Danila, Simonetta, Simona, Fugazzola, Laura, Dazzi, Davide, Pignataro, Lorenzo, Guastella, Claudio, Lazzaroni, Elisa, Pirola, Giacinta, and Salvi, Mario
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EYE movements , *EYE muscles , *QUALITY of life , *DIPLOPIA , *TREATMENT effectiveness - Abstract
Background: The overall changes of ocular motility in Graves' orbitopathy (GO) are not easily quantifiable with the methods currently available, especially in clinical studies. The aim of the present study was to calculate parameters that quantify the changes of ocular motility in GO in relation to the Gorman score for diplopia. Methods: We studied 100 GO patients (Group 1) and 100 controls (Group 2). We also included 30 patients treated with intravenous methylprednisolone (iv-MP), assessed at baseline and after 12 and 24 weeks (Group 3), and 66 patients submitted to squint surgery, assessed at baseline and after 12 weeks (Group 4). Ocular ductions were measured in four gaze directions by a perimeter arc and were used to calculate a total motility score (TMS) as the sum of ductions in each direction; a biocular TMS (b-TMS) as the sum of the TMS of two eyes; and an asymmetry ratio (AR) as the sum of the differences of the corresponding ductions between the two fellow eyes divided by the mean difference found in controls. Quality of life was accessed by a specific questionnaire (Graves' orbitopathy quality of life [GO-QoL] questionnaire). Results: TMS and b-TMS were lower, while AR was higher, in Group 1 compared with controls (p < 0.001). In Group 1, TMS and b-TMS were inversely correlated with the Gorman score (p < 0.001) and AR was higher in patients with constant diplopia compared with the others (p < 0.001). In Group 3, TMS and b-TMS increased after treatment in responders to iv-MP (p < 0.001). In Group 4, TMS and b-TMS improved in all patients after surgery (p < 0.01), while AR and GO-QoL score improved only in those without residual constant diplopia (p < 0.001). Conclusion: We describe a quantitative method to assess eye motility dysfunction in any stage of GO to be used as an outcome measure in clinical studies. [ABSTRACT FROM AUTHOR]
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- 2021
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7. MISS (minimalinvasive Schielchirurgie) zur Strabismuskorrektur.
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Höller, Ulrike, Friedheim, Monika, Huber, Margret, Leitner, Barbara, and Emesz, Martin
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Copyright of Spektrum der Augenheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2021
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8. Ocular-muscle surgery for filamentary keratitis that developed in double elevator palsy
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Hieda O, Yokoi N, and Sotozono C
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filamentary keratitis ,squint surgery ,double elevator palsy ,Medicine (General) ,R5-920 - Abstract
Osamu Hieda, Norihiko Yokoi, Chie Sotozono Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Purpose: To report a case of filamentary keratitis occurring in the cornea hidden under the eyelids by squint surgery.Methods: A 69-year-old female patient with a history of amblyopia was referred for intractable filamentary keratitis in the left eye. The strabismus angle was 35Δ hypertrophic, and ocular motility was within the normal range. Slit-lamp examination of her left eye revealed filamentary keratitis in more than one-third of the upper cornea behind the upper eyelid. Her right eye was diagnosed as supranuclear double elevator palsy. We performed strabismus surgery on her right eye, including inferior rectus muscle recession (5 mm) in combination with superior rectus muscle resection (5 mm) under local anesthesia. Following surgery, the left eye squint angle was improved. The filamentary keratitis of the left eye disappeared, and there was no recurrence over the following 5 years.Conclusion: The squint surgery of paralyzed right eye decreased the strabismus angle, subsequently resulting in the disappearance of the filamentary keratitis in the left eye via the resolution of the relative blepharoptosis. Although the squint operation performed was not for the purpose of improving binocular function, we want to conclude that it can treat the filamentary keratitis behind the eyelid. Keywords: filamentary keratitis, squint surgery, double elevator palsy, amblyopia
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- 2017
9. Ocular ductions after rectus muscle recession and resection in thyroid eye disease.
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Matlach, Juliane, Döllinger, Vera K. R., Eha, Judith, Elflein, Heike M., Weyer-Elberich, Veronika, Mildenberger, Philipp, and Pitz, Susanne
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THYROID eye disease , *RECESSIONS , *SURGICAL excision , *OPHTHALMIC surgery , *MUSCLES ,STRABISMUS surgery - Abstract
Background: Recession and resection of rectus muscles for correction of strabismus in Thyroid Eye Disease (TED) is relatively unpopular as it is assumed to enhance the restriction of ocular ductions. Therefore, the purpose of this study was to compare ductions of recession only and recess/resect procedures. Methods: We retrospectively reviewed the charts of 119 patients who underwent strabismus surgery for TED from 1991 to 2015, of which 102 were included in the present study. Forty-six interventions were performed on horizontal, 56 on vertical rectus muscles; comprising 41 recess/resect surgeries for horizontal deviations, and 7 in patients with vertical strabismus. Ocular ductions and alignment were evaluated preoperatively and at 3 and 12 months postoperatively. Results: Both recessions as well as recess/resect procedures resulted in improved abduction and elevation, respectively. At the exam 3 months postoperatively, median abduction for the recession only group and the recess/resect group were 27.5° and 35°, respectively. The similar figures for elevation were 25° and 10°, respectively. Neither were statistically significant. No restricted adduction or depression was seen in the recess/resect surgeries groups with lateral or superior rectus resection. None of the patients showed unusual postoperative inflammation or conjunctival scarring. Conclusion: In this retrospective analysis, we found an equal effect on ocular ductions in patients with TED when comparing recess/resect eye muscle surgery to recess only procedures. In TED patients with large horizontal angle deviations and abduction deficit, medial rectus recession and lateral rectus resection surgery can be considered. Muscle resections in TED do not seem to have a clinically relevant risk to increase the restriction of ocular ductions but rather improve ductions in the restricted directions of gaze. [ABSTRACT FROM AUTHOR]
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- 2019
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10. Horizontal Recti Muscle Plication Versus Resection in Squint Surgery.
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Kamel, Madeha Abdelfatah, Hasan, Zeinab Sayed, El Toukhi, El Sayed Mohammed, and Ali, Amani Mohammed
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SURGICAL excision , *MUSCLES , *BINOCULAR vision , *EYE contact , *BLOOD diseases ,STRABISMUS surgery - Abstract
Background: Strabismus surgery serves to align the visual axes to provide binocular single vision, or improve cosmesis, or restore normal eye contact, or enhance the quality of life. Objective: this study aims at evaluating muscle scleral plication technique as regards efficacy, stability, predictability and possible complications and comparing it to the standard resection technique. Patients and Methods: this study was carried out in the Ophthalmology Department in Al-Zahraa University Hospital and Research Institute of Ophthalmology between 2015 and 2018 on 40 patients. Their ages ranged from 1 to 40 years. 28 patients were males and 22 were females. 23 patients were exotropia and 17 patients were esotropia. Results: from this study it was found that the effect of plication is more or less the same as that of resection. But it can be noted that muscle scleral plication offers a safe, predictable, alternative to resection with no especially alarming complications that differ from those of ordinary strabismus surgery. This technique can be used instead of resection whenever there is fear of anterior segment ischaemia (ASI), such as when there is a possibility of operating on more than two rectus muscles or when the patient suffers from blood diseases or dysthyroid ophthalmopathy. Conclusion: from the results of this study, it can be concluded that the musclescleral plication technique is an easy alternative to resection that can be used on horizontal muscles especially when anterior ciliary vessels sparing is needed. [ABSTRACT FROM AUTHOR]
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- 2019
11. Ocular-muscle surgery for filamentary keratitis that developed in double elevator palsy.
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Osamu Hieda, Norihiko Yokoi, and Chie Sotozono
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EYE muscle surgery ,KERATITIS ,STRABISMUS surgery ,AMBLYOPIA ,BLEPHAROPTOSIS - Abstract
Purpose: To report a case of filamentary keratitis occurring in the cornea hidden under the eyelids by squint surgery. Methods: A 69-year-old female patient with a history of amblyopia was referred for intractable filamentary keratitis in the left eye. The strabismus angle was 35Δ hypertrophic, and ocular motility was within the normal range. Slit-lamp examination of her left eye revealed filamentary keratitis in more than one-third of the upper cornea behind the upper eyelid. Her right eye was diagnosed as supranuclear double elevator palsy. We performed strabismus surgery on her right eye, including inferior rectus muscle recession (5 mm) in combination with superior rectus muscle resection (5 mm) under local anesthesia. Following surgery, the left eye squint angle was improved. The filamentary keratitis of the left eye disappeared, and there was no recurrence over the following 5 years. Conclusion: The squint surgery of paralyzed right eye decreased the strabismus angle, subsequently resulting in the disappearance of the filamentary keratitis in the left eye via the resolution of the relative blepharoptosis. Although the squint operation performed was not for the purpose of improving binocular function, we want to conclude that it can treat the filamentary keratitis behind the eyelid. [ABSTRACT FROM AUTHOR]
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- 2017
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12. Parental perspectives on surgical fees of pediatric squint surgeries
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Mihir Kothari and Sheetal Baldua
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Medical reimbursement ,private practice ,squint surgery ,surgical fees ,Ophthalmology ,RE1-994 - Abstract
Aim: To report the parental feedback on the ′squint surgery fees′ of their ward in an urban private practice. Design: Prospective cohort study. Subjects and Methods: Three months after the surgery, a 10 item questionnaire was administered on the parents of the children who underwent a squint surgery. Multivariate analysis was performed. Results: The parents of 46 children were included. Thirty-three respondents were fathers. The educational status ranged from 6 th grade to postgraduates including doctors. Four respondents refused to disclose the income. The mean total and per capita monthly income of the families were 59,590/- INR (Indian Rupees) and 14,670/- INR, respectively. Thirteen parents found the surgical charges inappropriate. Concession was demanded when the total cost of surgery (28,417/- INR) exceeded the per capita income of the family (10,149/- INR) by three times. The most appropriate cost of the surgery adjudged by the parents was two times the per capita income. The "appropriateness of the fees" had no correlation with the outcome (P = 0.4). All the parents recommended heavy concession in the fees for the reoperations. The quality of the medical expertise was considered the most important determinant of the surgical fees. Of 18 children with mediclaim, 12 had rejection due to ′congenital′ nature of the disease. Two were considered "cosmetic". Conclusions: In a private practice, the parental feedback on fees is desirable to make surgical services demand sensitive. Clinician should avoid the term "congenital" in the medical records and loudly express, "restoration of binocular vision" as the indication of squint surgery in children.
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- 2014
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13. Surgical strategy for third nerve palsy with aberrant regeneration: Harnessing the aberrant power
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Abhijit Rasal, Pradeep Sharma, Shweta Chaurasia, and Pranav Kishore
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Adult ,medicine.medical_specialty ,aberrant regeneration ,Surgical strategy ,Adolescent ,genetic structures ,Ophthalmologic Surgical Procedures ,pseudo-graefe's sign ,Nerve palsy ,Positive correlation ,pseudo-graefe‘s sign ,Young Adult ,Ptosis ,third nerve palsy ,lcsh:Ophthalmology ,inverse-duane‘s sign ,fixation duress ,Oculomotor Nerve Diseases ,medicine ,Humans ,Squint surgery ,Child ,Retrospective Studies ,Fixation (histology) ,Diplopia ,Vision, Binocular ,business.industry ,medicine.disease ,eye diseases ,Surgery ,Ophthalmology ,Treatment Outcome ,Oculomotor Muscles ,lcsh:RE1-994 ,Exotropia ,Original Article ,inverse-duane's sign ,medicine.symptom ,business - Abstract
Our study aimed to evaluate the outcome of contralateral eye (CE) fixation duress squint surgery (FDSS) in third nerve palsy (3rd NP) with aberrant regeneration and compare the postoperative ptosis correction with preoperative ptosis improvement on adduction. Methods: Patients of 3rd NP with aberrant regeneration who underwent CE FDSS between December 2012‑July 2015 in a tertiary‑care eye hospital with a follow‑up period of 1‑year were retrospectively studied to analyze preoperative and postoperative details. Surgical success was defined as the correction of ptosis within 1 mm of preoperative ptosis improvement during maximal adduction of the affected eye, postoperative alignment ≤10Δ, and resolution of subjective diplopia in primary position. Results: A total of 14 eyes in 14 patients (mean age 23.6 ± 13.6 years) were included. Mean preoperative exotropia and ptosis in primary position in 14 patients was 53.4 ± 20pd and 4.89 ± 2.9 mm, respectively, and mean hypotropia in 6 patients was 23.67 ± 5.89pd. The mean improvement of ptosis on adduction and supraduction in all patients was 4.07 ± 2.64 mm and 2.89 ± 2.22 mm, respectively (P = 0.213). All patients underwent large recession of CE lateral rectus (mean 12.4 ± 2.7 mm), 9 patients underwent CE medial rectus resection/plication (mean 6.0 ± 0.9 mm) and 6 patients underwent CE superior rectus recession (mean 6.6 ± 0.67 mm). Postoperatively, mean ptosis and exotropia correction was 3.7 ± 2.4 mm (P = 0.000) and 15 ± 9.6pd (P = 0.000), respectively, and mean hypotropia was 2.17 ± 4.02pd (P = 0.000). Surgical success was achieved in 6 patients. Postoperative ptosis correction showed strong positive correlation with preoperative improvement of ptosis on adduction (r = 0.87; P = 0.00). Conclusion: Preoperative lid excursion on adduction in 3rd NP can be regarded as a prognostic sign of the success of CE FDSS which can simultaneously correct both ptosis and squint.
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- 2021
14. A Review of Minimally Invasive Strabismus Surgery (MISS): Is This the Way Forward?
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Asproudis, Ioannis, Kozeis, Nikolaos, Katsanos, Andreas, Jain, Saurabh, Tranos, Paris, Konstas, Anastasios-Georgios, Tranos, Paris G, and Konstas, Anastasios-Georgios P
- Abstract
Minimally invasive surgery is rapidly becoming the norm in medicine, as it often leads to better outcomes and earlier rehabilitation. This article reviews the principles and different techniques employed to perform minimally invasive strabismus surgery (MISS). In these techniques, strabismus surgery is performed through keyhole openings, thus reducing the risk of postoperative corneal complications, minimizing postoperative discomfort, and better preserving muscle function. MISS can be used to perform all types of strabismus surgery, namely rectus muscle recessions, resections, plications, reoperations, retroequatorial myopexy, transpositions, oblique muscle recessions, or plications even in the presence of limited motility. Of note, ocular alignment outcomes with MISS versus more traditional techniques have not been compared in randomized trials. Consequently, more controlled evidence is still needed to better delineate the future role and value of MISS in clinical management. [ABSTRACT FROM AUTHOR]
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- 2017
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15. Outcomes of Squint Surgery in Terms of Motor Alignment within 10 Prism Diopters in a Tertiary Care Hospital: A Clinical Audit
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Sharmeen Akram, Asma Rahman, and Shaukat Ali Chhipa
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Clinical audit ,Pediatrics ,medicine.medical_specialty ,Visual acuity ,genetic structures ,business.industry ,Tertiary care hospital ,medicine.disease ,University hospital ,eye diseases ,Ophthalmology ,medicine ,Prism diopters ,Squint surgery ,medicine.symptom ,business ,Esotropia ,Exotropia - Abstract
Purpose: To determine the outcome of squint surgery in terms of motor ocular alignment within 10 prism diopters, in a tertiary care hospital. Study Design: A clinical audit at a tertiary care hospital. Place and Duration of Study: The study was conducted in Ophthalmology department, of Aga khan university hospital, Karachi between December 2016 and June 2017. Methods: Medical records of all patients who underwent squint surgery were retrieved and included in the study. Patients with amblyopia, corneal or retinal pathologies and those who lost to follow-up or with incomplete records were excluded. All the available demographic and clinical data including pre-operative visual acuity, squint measurements, procedure performed and post-operative ocular alignment up to maximum of 6 months of follow-up was compiled. Results: One hundred and nineteen patients fulfilled the inclusion criteria. There were 54.6% males and 45.4% were females. Squint was unilateral in 75.4% of patients and bilateral in 24.5%. Exotropia was present in 74 (62%) and Esotropia in 45 (38%) patients. The frequency of post-operative outcomes among the study participants were analyzed and it was reported that at six months follow-up central straight eye position or squint less than 10 prism diopters was seen among 75.5% of patients. The association of age and gender with primary outcome was obtained by applying independent sample T test. All the categories of age and gender showed statistically significant results i.e. p-value ≤ 0.05, except one week follow-up among different categories of gender showing insignificant results with p value = 0.740. Conclusion: In present study 75.5% patients achieved the required result of ocular alignment within 10 prism diopters of orthotropia at the final follow-up visit. Key Words: Squint, Esotropia, Exotropia, 10 prism Diopters.
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- 2021
16. General Anesthesia Plus Muscle Relaxant in a Patient with Kugelberg Welander Disease: A Case Report
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Ebrahim Espahbodi, Amir Abbas Yaghooti, Hossein Sadrossadat, Mehrdad Shoroughi, Alireza Ebrahim Soltani, Mehrdad Goudarzi, and Mehdi Sanatkar
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spinal muscular atrophy ,squint surgery ,muscle relaxant ,Anesthesiology ,RD78.3-87.3 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Spinal muscular atrophies (SMAs) represent a rare group of inherited disorders that cause progressive degeneration of the anterior horn cells of the spinal cord. The exact cause of the degeneration is unknown. Loss of these cells results in a progressive lower motor neuron disease that has no sensory involvement and that is manifested as hypotonia, weakness, and progressive paralysis. Kugelberg Welander spinal muscular atrophy (also known as Wohlfart-Kugelberg-Welander syndrome or mild SMA) is a milder form of SMA, with symptoms typically presenting after age 18 months. Here in we report a case of anesthetic management of a patient with Kugelberg Welander disease who was refered for squint surgery and also we reviewed some other cases of SMA patients receiving different types of anesthesia.
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- 2015
17. Surgical Technique and Results of Orbital Decompression in Graves’ Disease
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Geyer, G., Brunner, F. X., Buschmann, W., Müller, J., and Samii, M., editor
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- 1991
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18. Orthoptics
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McNamara, Rowena, Perry, John P., editor, and Tullo, Andrew B., editor
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- 1990
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19. Irksome Preseptal Cellulitis Following Squint Surgery- A Case Report
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Prerana Tripathi, C. Vidhya, and Tarika Perikal
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medicine.medical_specialty ,business.industry ,Cellulitis ,medicine ,Squint surgery ,General Medicine ,medicine.disease ,business ,Surgery - Published
- 2020
20. Combination therapy of low-fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane in choroidal osteoma
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Rodney J Morris, Varsha V Prabhu, Parag K Shah, and V Narendran
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Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Caesarean section ,epidural anesthesia ,Horner′s syndrome ,Acute myeloid leukemia ,hypopyon ,masquerade syndrome ,Low-fluence photodynamic therapy ,choroidal neovascular membrane ,choroidal osteoma ,ranibizumab ,Ophthalmology ,RE1-994 - Abstract
Choroidal osteoma is an unusual form of intraocular calcification seen in otherwise healthy eyes. It is a benign idiopathic osseous tumor of the choroid, typically seen in young females. Choroidal neovascular membrane (CNVM) is a complication seen in one-third of these patients and carries a poor visual outcome. We report a case of a 25-year-old hyperthyroid female with choroidal osteoma and subfoveal CNVM in her left eye which was successfully treated using low-fluence photodynamic therapy (PDT) with verteporfin followed by a single injection of intravitreal ranibizumab.
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- 2011
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21. Feed back of the parents and / or relatives witnessing a squint surgery of their ward in the operation theater
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Mihir Kothari
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Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Ophthalmology ,RE1-994 - Abstract
The aim of the study was to know the response of the relatives attending the squint surgery of their ward. A trained secretary administered an eight item questionnaire by live / telephonic interview. Of the 44 attendees, two left the Operation Theater before completion of the surgery. Mean age of the patients was 7.2 years ± 7.8 and that of the attendees was 36.1 years ± 8.5. Forty patients had a surgery under general anesthesia and four under local anesthesia. Eleven (25%) attendees experienced an increase in anxiety. Thirty-six (82%) attendees reported increased transparency, 38 (86%) reported increased confidence, and 43 (98%) reported increased awareness. None found any disadvantage. Twenty-seven (61%) recommended this practice for all and 16 (36%) recommended the practice selectively. The internal validity of the questionnaire was fair (Cronbach′s Alpha = 0.6). It was concluded that the presence of relatives in the Operation Theater during the surgery could bring in more transparency, accountability, confidence, awareness, and trust.
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- 2011
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22. Unusual case of persistent Horner′s syndrome following epidural anaesthesia and caesarean section
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Shubhra Goel and Cat Nguyen Burkat
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Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Caesarean section ,epidural anesthesia ,Horner′s syndrome ,Ophthalmology ,RE1-994 - Abstract
This is a rare case of persistent Horner′s syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) of head, neck, and chest were unremarkable. Medline search using terms Horner′s, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles describing Horner′s syndrome in obstetric epidural anesthesia, of which 11 were following Caesarean section. The increased incidence of Horner′s syndrome in the setting of epidural anesthesia in pregnancy may be related to epidural venous engorgement and cephalic spread of the local anaesthetic, with disruption in the oculosympathetic pathway. It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner′s syndrome in a postpartum female. Rarely, the ptosis may be permanent and require surgical intervention.
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- 2011
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23. Application of ultrasound biomicro-scopy in the planning of cataract surgery in anterior megalophthalmos
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Mohammad Ali Zare, Bahram Eshraghi, Mohammad Yaser Kiarudi, and Ebrahim Azaripour Masoule
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Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Caesarean section ,epidural anesthesia ,Horner′s syndrome ,Acute myeloid leukemia ,hypopyon ,masquerade syndrome ,Low-fluence photodynamic therapy ,choroidal neovascular membrane ,choroidal osteoma ,ranibizumab ,Cataract surgery ,perfluorocarbon liquid ,postoperative inflammation ,Bilateral keratoconus ,granular dystrophy ,late occurrence ,Anterior megalophthalmos ,cataract ,ultrasound biomicroscopy ,Ophthalmology ,RE1-994 - Abstract
Anterior megalophthalmos, a rare hereditary disorder, is macrocornea (horizontal corneal diameter more than 13 mm) in association with enlarged lens-iris diaphragm and ciliary ring. One of the major challenging issues in the cataract surgery of these patients is preventing intraocular lens (IOL) malposition, because of probable large capsular bag. Several approaches have been selected by previous surgeons, such as, custom-made anterior chamber IOLs. In this study, we show a normal capsular bag diameter despite ciliary ring enlargement, with application of ultrasound biomicroscopy (UMB). We suggest that in cases of anterior megalophthalmos without phacodonesis, UBM could measure the actual size of the capsular bag and obviate the need for further procedures.
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- 2011
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24. Relapsing acute myeloid leukemia presenting as hypopyon uveitis
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Sapna P Hegde, Atul T Ursekar, and Ajay A Chitale
- Subjects
Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Caesarean section ,epidural anesthesia ,Horner′s syndrome ,Acute myeloid leukemia ,hypopyon ,masquerade syndrome ,Ophthalmology ,RE1-994 - Abstract
Anterior segment infiltration in acute myeloid leukemia (AML) presenting as hypopyon uveitis is very rare. We report this case as an uncommon presentation in a patient on remission after bone marrow transplant for AML. In addition to the hypopyon, the patient presented with "red eye" caused by ocular surface disease due to concurrent graft-versus-host disease and glaucoma. The classical manifestations of masquerade syndrome due to AML were altered by concurrent pathologies. Media opacities further confounded the differential diagnosis. We highlight the investigations used to arrive at a definitive diagnosis. In uveitis, there is a need to maintain a high index of clinical suspicion, as early diagnosis in ocular malignancy can save sight and life.
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- 2011
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25. Delayed inflammation associated with retained perfluorocarbon liquid
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S Pradeep, Jay K Chhablani, Bhavin Patel, and Padmaja Rani
- Subjects
Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Caesarean section ,epidural anesthesia ,Horner′s syndrome ,Acute myeloid leukemia ,hypopyon ,masquerade syndrome ,Low-fluence photodynamic therapy ,choroidal neovascular membrane ,choroidal osteoma ,ranibizumab ,Cataract surgery ,perfluorocarbon liquid ,postoperative inflammation ,Ophthalmology ,RE1-994 - Abstract
A 55-year-old woman, with history of cataract surgery 1 year back, presented with features of ocular inflammation for last 3 months. She had no history of any other intraocular surgery. On examination, anterior segment showed frothy material in the inferior angle with moderate anterior chamber reaction (cells+/flare+) and sulcus intraocular lens with large posterior capsule rent. Fundoscopy showed multiple, small to medium-sized transparent bubbles of perfluorocarbon liquid (PFCL) with membranes in the vitreous cavity. Ultrasonography confirmed the presence of PFCL in the vitreous cavity. Pars plana vitrectomy with anterior chamber wash was done which led to good visual recovery. To conclude, retained PFCL can cause late onset fibrinous inflammation after a quiescent period but surgical intervention may lead to good visual outcome.
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- 2011
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26. Late occurrence of granular dystrophy in bilateral keratoconus: Penetrating keratoplasty and long-term follow-up
- Author
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Varsha M Rathi, Geeta K Vemuganti, Virender S Sangwan, and Chitra Kannabiran
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Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Caesarean section ,epidural anesthesia ,Horner′s syndrome ,Acute myeloid leukemia ,hypopyon ,masquerade syndrome ,Low-fluence photodynamic therapy ,choroidal neovascular membrane ,choroidal osteoma ,ranibizumab ,Cataract surgery ,perfluorocarbon liquid ,postoperative inflammation ,Bilateral keratoconus ,granular dystrophy ,late occurrence ,Ophthalmology ,RE1-994 - Abstract
We report a rare case of keratoconus with granular dystrophy with a follow-up of two decades, documenting the sequential presentation of two diseases confirmed by histology and genetic studies. A 13-year-old boy was diagnosed in 1988 with keratoconus in both eyes (BE) based on slit-lamp biomicroscopy findings of corneal ectasia in BE accompanied by Fleischer′s ring, Vogt′s striae, a small, old, healed hydrops. The left eye (LE) had central corneal thinning and scar in the central area involving the mid and posterior stroma secondary to healed hydrops. Penetrating keratoplasty (PKP) was advised. The boy was lost to follow-up till 1991 and presented with white, dot-like opacities in the central cornea in the RE only, suggestive of granular corneal dystrophy. Similar findings of white, dot-like opacities were noted in the LE in 1995 and the patient subsequently underwent PKP in BE. Histopathology of corneal buttons confirmed the presence of patchy, crystal-like orange deposits, which stained bright red with Masson′s trichrome. Mutational analysis of the TGFBI gene in patient′s DNA revealed a heterozygous mutation corresponding to a change in Arg555Trp in the keratoepithelin protein. Granular dystrophy recurred after 8 years in the RE.
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- 2011
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27. Recovery of Stereopsis After Squint Surgery: A Case Report
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Rajib Mandal
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Stereopsis ,genetic structures ,business.industry ,Medicine ,Optometry ,Squint surgery ,sense organs ,business ,eye diseases - Abstract
Exophoria (X) may be defined as an outward deviation of the eyes. This may deteriorate to constant exotropia (XT), resulting in partial or complete loss of stereo-acuity and other sensory parameters. Studies have shown a good outcome of stereo-acuity in intermittent exotropia patients with surgical correction. This present 19-year-old female subject with 70 PD strabismus in LE was treated with surgical and therapeutic intervention resulting in stable binocular coordination, a remarkable improvement of stereo-acuity (from < 480 sec of arc to 30 sec of arc). The therapy plan was designed to perform in three stages including 1 hr office-based therapy once a week along with hometherapy for 30 min everyday for 5 months. Anti- suppression therapy was planned in the first stage to restore bi-ocular vision whereas second and final stage therapy was designed for recovery of fusion, accommodation, and stereo-acuity. To understand and conclude regarding improvement, pre and post vision therapy data were compared.
- Published
- 2021
28. Quantification of Global Ocular Motility Impairment in Graves' Orbitopathy by Measuring Eye Muscle Ductions
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Campi, I., Curr��, N., Vannucchi, G., Covelli, D., Simonetta, S., Fugazzola, L., Dazzi, D., Pignataro, L., Guastella, C., Lazzaroni, E., Pirola, G., and Salvi, M.
- Subjects
genetic structures ,Graves' ,clinical trials ,diplopia ,ocular ductions ,orbitopathy ,rehabilitation ,squint surgery ,eye diseases - Abstract
Background:The overall changes of ocular motility in Graves' orbitopathy (GO) are not easily quantifiable with the methods currently available, especially in clinical studies. The aim of the present study was to calculate parameters that quantify the changes of ocular motility in GO in relation to the Gorman score for diplopia.Methods:We studied 100 GO patients (Group 1) and 100 controls (Group 2). We also included 30 patients treated with intravenous methylprednisolone (iv-MP), assessed at baseline and after 12 and 24 weeks (Group 3), and 66 patients submitted to squint surgery, assessed at baseline and after 12 weeks (Group 4). Ocular ductions were measured in four gaze directions by a perimeter arc and were used to calculate a total motility score (TMS) as the sum of ductions in each direction; a biocular TMS (b-TMS) as the sum of the TMS of two eyes; and an asymmetry ratio (AR) as the sum of the differences of the corresponding ductions between the two fellow eyes divided by the mean difference found in controls. Quality of life was accessed by a specific questionnaire (Graves' orbitopathy quality of life [GO-QoL] questionnaire).Results:TMS and b-TMS were lower, while AR was higher, in Group 1 compared with controls (p< 0.001). In Group 1, TMS and b-TMS were inversely correlated with the Gorman score (p< 0.001) and AR was higher in patients with constant diplopia compared with the others (p< 0.001). In Group 3, TMS and b-TMS increased after treatment in responders to iv-MP (p< 0.001). In Group 4, TMS and b-TMS improved in all patients after surgery (p< 0.01), while AR and GO-QoL score improved only in those without residual constant diplopia (p< 0.001).Conclusion:We describe a quantitative method to assess eye motility dysfunction in any stage of GO to be used as an outcome measure in clinical studies.
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- 2021
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29. Surrendering control, or nothing to lose: Parents’ preferences about participation in a randomised trial of childhood strabismus surgery.
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Buck, Deborah, Hogan, Vanessa, Powell, Christine J., Sloper, John J., Speed, Chris, Taylor, Robert H., Tiffin, Peter, and Clarke, Michael P.
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STRABISMUS surgery ,INTERVIEWING ,RESEARCH methodology ,RESEARCH funding ,STATISTICAL sampling ,QUALITATIVE research ,THEMATIC analysis ,RANDOMIZED controlled trials ,PARENT attitudes - Abstract
Background Intermittent exotropia is the most common form of divergent strabismus (squint) in children. Evidence regarding its optimum management is limited. A pilot randomised controlled trial has recently been completed (Surgery versus Active Monitoring in Intermittent Exotropia trial) to determine the feasibility of a full randomised controlled trial. Purpose To identify drivers for and barriers against parents’ participation in Surgery versus Active Monitoring in Intermittent Exotropia and to seek their views on information received, the need for randomisation, and enhancing acceptability. Methods Multiple method qualitative study using semi-structured telephone interviews to explore parents’ motivations and trial screening logs to provide an indication of common barriers. Exploratory thematic analysis identified key themes. Results A total of 48 interviews were conducted (14 participants; 34 non-participants). Barriers included no desire for surgery/preference to ‘wait and see’, wanting surgery immediately, feeling uncomfortable about ‘surrendering control’ over decision-making/being managed ‘at random’, lack of confidence in the effectiveness of surgery, believing the risks outweighed the benefits, and lack of trust. Drivers included desiring surgery, ‘nothing to lose’, benefits offsetting the risks, and being in a trial would result in better care. Some also mentioned ‘doing their bit’ for research. Suggestions for enhancing acceptability included allowing choice of treatment group, giving more time for decision-making, expanding on information given, and improving communication. Many felt the necessity of randomisation was adequately explained, but there was some indication that it was misunderstood. Information extracted from the screening logs of 80/89 eligible non-participants indicated the most prevalent barrier was not wanting surgery/preferring to observe (56%), followed by desiring surgery straightaway (15%). Opposition to randomisation/wanting to retain control was recorded in 9% of cases as was the belief that the child’s squint was not severe enough to warrant surgery. Limitations Interviews were not audio-recorded. Not all who consented to interview could be contacted, although the response/contact rate was good (48/62). A few parents did not provide reasons for refusing the trial. Conclusion Opposition to surgery and concerns about surrendering control were common obstacles to participation, whereas parents keen for their child to undergo the operation but happy to defer tended to embrace a ‘nothing to lose’ attitude. Many non-participants would have consented if allowed to choose group, although most of these would have chosen observation. While most parents felt happy with information given and that randomisation was adequately explained, it is of concern that there may be some misunderstanding, which should be addressed in any trial. These findings will inform future trials in childhood exotropia, for example, consideration of preference arms and improving communication. Lessons learnt from the Surgery versus Active Monitoring in Intermittent Exotropia trial could prove valuable to paediatric and surgical trials generally. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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30. Types of Pattern Strabismus and Their Surgical Outcomes after Adjustable Strabismus Surgery
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Sana Nadeem
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Adjustable suture ,medicine.medical_specialty ,genetic structures ,business.industry ,Rectus muscle ,eye diseases ,Surgery ,Ophthalmology ,Muscle transposition ,Prism diopters ,medicine ,Squint surgery ,Strabismus ,business ,Orthoptic ,Strabismus surgery - Abstract
Purpose: To study the different types of pattern strabismus and their surgical outcomes after adjustable strabismus surgery. Study Design: Prospective, interventional study. Place and Duration of Study: Eye department, Fauji Foundation Hospital, Rawalpindi (June, 2016 to March, 2019). Methods: A total of 40 consecutive patients with pattern strabismus were included in the study. After complete orthoptic assessment, the patients underwent either rectus muscle transposition or oblique muscle surgery, by adjustable squint surgery. The pre-operative evaluation of different strabismus patterns, deviations, and post-operative results were measured and analyzed. The amount of postoperative pattern change was measured at 6 weeks postoperatively, to assess the success of the surgeries. Results: Out of 40 patients, 33 were females and 7 were males. The age ranged from 7 to 69 years (mean 18.05 ± 9.6). All patients were operated by using adjustable suture technique. “V” pattern was seen in 26 cases (65%) and “A” pattern was seen in 12 (30%) cases. The mean preoperative pattern was 13.2 ± 8.09 PD (prism diopters), and the mean postoperative pattern was 2.05 ± 2.96 PD. Surgical success was defined as the amount of pattern collapse at 6 weeks, the period at which a stable alignment was achieved. The difference between the preoperative and postoperative pattern deviation was statistically significant (p = 0.000). Correction of the pattern was seen in 92.5% of patients at average follow up of 50.87 ± 14.02 days. Conclusions: Pattern Strabismus can be corrected by varying rectus muscle transpositions or oblique muscle surgery during routine adjustable strabismus surgery. Key Words: Strabismus, V pattern, A pattern, Y pattern, X pattern, lambda pattern, muscle transposition.
- Published
- 2020
31. Quantification of Global Ocular Motility Impairment in Graves' Orbitopathy by Measuring Eye Muscle Ductions
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Davide Dazzi, Lorenzo Pignataro, Guia Vannucchi, Danila Covelli, Nicola Currò, Simona Simonetta, Laura Fugazzola, Claudio Guastella, Giacinta Pirola, Elisa Lazzaroni, Irene Campi, and Mario Salvi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Eye Movements ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Eye muscle ,Methylprednisolone ,Severity of Illness Index ,Young Adult ,Endocrinology ,Predictive Value of Tests ,Ophthalmology ,medicine ,Diplopia ,Squint surgery ,Humans ,skin and connective tissue diseases ,Eye Movement Measurements ,Glucocorticoids ,Aged ,Retrospective Studies ,Aged, 80 and over ,Rehabilitation ,business.industry ,Ocular motility ,Middle Aged ,eye diseases ,Clinical trial ,Graves Ophthalmopathy ,Treatment Outcome ,Oculomotor Muscles ,Quality of Life ,Administration, Intravenous ,Female ,sense organs ,medicine.symptom ,business - Abstract
Background: The overall changes of ocular motility in Graves' orbitopathy (GO) are not easily quantifiable with the methods currently available, especially in clinical studies. The aim of the prese...
- Published
- 2020
32. Pain Score in Adjustable Strabismus Surgery
- Author
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Sana Nadeem
- Subjects
Adjustable suture ,medicine.medical_specialty ,Pain score ,Pain experience ,business.industry ,Worst Possible Pain ,Surgery ,Ophthalmology ,Suture (anatomy) ,medicine ,Squint surgery ,Prospective cohort study ,business ,Strabismus surgery - Abstract
Purpose: To assess the pain experienced by patients at the time of suture adjustment using topical proparacaine hydrochloride 0.5% anesthesia, in adjustable suture strabismus surgery. Study Design: Prospective, interventional study. Place and Duration of Study: Eye department of Fauji Foundation Hospital, Rawalpindi from May, 2017 to March, 2019. Material and Methods: A prospective study was carried out to assess the pain experience of patients undergoing suture adjustment under topical proparacaine hydrochloride 0.5% anesthesia, during routine adjustable squint surgery. All surgeries were performed under general anesthesia with suture adjustment done 1 hour or more after surgery when the effects of general anesthesia had worn off. Horizontal and vertical muscle recessions and resections were included along with inferior oblique surgeries, and transposition procedures. The patients were given the ‘Wong-Baker FACES® Pain rating Scale’; along with a ‘Numeric Pain Rating Scale’ from 0 to 10 (0 signifying ‘no pain’ and 10 signifying ‘worst possible pain’) on a proforma. The response of the patients was noted. Results: Thirty three patients who underwent adjustable strabismus surgery were included in this study. The mean age was 19.1 ± 11.1 years. The average number of muscles operated upon for each patient were 2.87 ± 1.08. The patients’ response to the ‘Wong-Baker FACES® Pain rating Scale’ ranged from 0 to 8, with a mean of 2.03 ± 1.81 SD. On the ‘Numeric Pain Rating Scale’ a similar response was obtained with a mean of 2.0 ± 1.82 SD. Augmentation of anesthesia was not needed in any patient. Conclusion: Adjustment of sutures under topical proparacaine hydrochloride 0.5% anesthesia after strabismus surgery is a practical, comfortable and safe procedure.
- Published
- 2020
33. Ocular-muscle surgery for filamentary keratitis that developed in double elevator palsy
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Norihiko Yokoi, Osamu Hieda, and Chie Sotozono
- Subjects
medicine.medical_specialty ,genetic structures ,filamentary keratitis ,Case Report ,03 medical and health sciences ,Inferior rectus muscle ,0302 clinical medicine ,Cornea ,medicine ,Local anesthesia ,Filamentary keratitis ,Strabismus ,squint surgery ,amblyopia ,business.industry ,General Medicine ,eye diseases ,Surgery ,medicine.anatomical_structure ,double elevator palsy ,030221 ophthalmology & optometry ,sense organs ,Eyelid ,business ,030217 neurology & neurosurgery ,Superior rectus muscle ,Strabismus surgery - Abstract
Purpose To report a case of filamentary keratitis occurring in the cornea hidden under the eyelids by squint surgery. Methods A 69-year-old female patient with a history of amblyopia was referred for intractable filamentary keratitis in the left eye. The strabismus angle was 35Δ hypertrophic, and ocular motility was within the normal range. Slit-lamp examination of her left eye revealed filamentary keratitis in more than one-third of the upper cornea behind the upper eyelid. Her right eye was diagnosed as supranuclear double elevator palsy. We performed strabismus surgery on her right eye, including inferior rectus muscle recession (5 mm) in combination with superior rectus muscle resection (5 mm) under local anesthesia. Following surgery, the left eye squint angle was improved. The filamentary keratitis of the left eye disappeared, and there was no recurrence over the following 5 years. Conclusion The squint surgery of paralyzed right eye decreased the strabismus angle, subsequently resulting in the disappearance of the filamentary keratitis in the left eye via the resolution of the relative blepharoptosis. Although the squint operation performed was not for the purpose of improving binocular function, we want to conclude that it can treat the filamentary keratitis behind the eyelid.
- Published
- 2017
34. Squint Surgery in TED - Hints and Fints, or Why Graves' Patients Are Difficult Patients.
- Author
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Nardi, M.
- Subjects
- *
OPHTHALMIC surgery , *GRAVES' disease , *EYE movements , *MYOSITIS , *FIBROSIS , *PARALYSIS , *THERAPEUTICS - Abstract
Endocrine ophthalmopathy is the most common cause of acute onset diplopia in middle aged or older individuals. Ocular muscle involvement is characterized by myositis followed by fibrosis: this causes a stiffness and a shortening of the muscles involved with restriction of ocular movements: so the impairment of rotation is due to a mechanical obstacle and not to a paresis. Prisms are rarely useful in relieving diplopia and the majority of symptomatic patients need squint surgery. Timing of surgery is very important and two considerations are to be kept in mind: first, the systemic disease must be in remission and the ocular deviation must be stable for at least six months; second, if more than one surgical procedure is needed for the ophthalmopathy, muscle surgery has its right place after orbital surgery and before lid surgery. Obviously dealing with restrictive disorders, surgery is based on weakening procedures of the affected muscles: identifying the affected muscles is of crucial importance and may be sometime difficult for the presence of misleading signs; great advances have been made in surgical technique with the development of adjustable sutures and of topical anesthesia. Prognosis is usually good with more than 80% of patients recovering a useful field of binocular single vision with one procedure and more than 90% with two or more procedures. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
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35. Nationwide study of hospitalization and surgical treatment for childhood strabismus in Italy between 1999 and 2004.
- Author
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Ricci, Benedetto, Coppola, Giovanni, Ricci, Valentina, and Ziccardi, Lucia
- Abstract
Surgery for strabismus is in decline in countries like the United Kingdom. The aim of the present study was to determine whether this trend is also present in Italy and, also, to ascertain the number of squint operations performed in a six-year period. A retrospective review of all discharge summaries and procedures performed (diagnostic and therapeutic) for strabismus in Italian children aged 0–14 years old in the period 1999–2004 was undertaken. The total number of surgical procedures was 21,204. The number (per 10,000) was 4.24 in 1999, 4.33 in 2000, 4.31 in 2001, 4.25 in 2002, 4.23 in 2003, and 4.05 in 2004. The figure for 2004 was reduced by 4.48% with respect to 1999 and by 6.46% with respect to 2000. Temporal analysis revealed that the total number of single-muscle procedures remained stable for the first two years and then decreased in 2001 and 2002, and, above all, in 2003 and 2004. No significant change was noted in the number of procedures involving two or more muscles. It is also noteworthy that very few operations for strabismus were performed on children less than one year of age. The trend revealed by our data cannot be compared to the overall reduction in strabismus surgery that has been observed in England and Ontario, but there was a moderate decrease in the frequency of single-muscle surgical procedures among Italian children aged 0–14 years old in 2003 and 2004. Further investigation is needed to determine how this trend has evolved since 2004. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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36. The aetiology and management of long-lasting sixth nerve palsy in ophthalmoplegic migraine.
- Author
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Manzouri, B., Sainani, A., Plant, G. T., Lee, J. P., and Sloper, J.
- Subjects
- *
EYE paralysis , *MIGRAINE , *ETIOLOGY of diseases , *DIPLOPIA , *BOTULINUM toxin ,STRABISMUS surgery - Abstract
The features and management of two adult patients with ophthalmoplegic migraine and longlasting sixth nerve palsies are described. Both had had previous shorter episodes of diplopia following migraine-like headaches. One recovered following an injection of botulinum toxin to the medial rectus of her affected eye 11 months after the onset of diplopia. The other patient had previously had surgery for a consecutive divergent squint and required further squint surgery to realign his eyes 1 year after the onset of his sixth nerve palsy. Both botulinum toxin and squint surgery may be useful in the management of longstanding sixth nerve palsy in patients with ophthalmoplegic migraine. The aetiology of ophthalmoplegic migraine is discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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37. A Review of Minimally Invasive Strabismus Surgery (MISS): Is This the Way Forward?
- Author
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Andreas Katsanos, Anastasios-Georgios Konstas, Nikolaos Kozeis, Saurabh Jain, Ioannis Asproudis, and Paris Tranos
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Pharmacology toxicology ,Ophthalmologic Surgical Procedures ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Squint surgery ,Pharmacology (medical) ,Medicine(all) ,Rehabilitation ,business.industry ,Rectus muscle ,General Medicine ,eye diseases ,Ocular alignment ,Surgery ,Strabismus ,Oculomotor Muscles ,Invasive surgery ,030221 ophthalmology & optometry ,sense organs ,business ,030217 neurology & neurosurgery ,Strabismus surgery - Abstract
Minimally invasive surgery is rapidly becoming the norm in medicine, as it often leads to better outcomes and earlier rehabilitation. This article reviews the principles and different techniques employed to perform minimally invasive strabismus surgery (MISS). In these techniques, strabismus surgery is performed through keyhole openings, thus reducing the risk of postoperative corneal complications, minimizing postoperative discomfort, and better preserving muscle function. MISS can be used to perform all types of strabismus surgery, namely rectus muscle recessions, resections, plications, reoperations, retroequatorial myopexy, transpositions, oblique muscle recessions, or plications even in the presence of limited motility. Of note, ocular alignment outcomes with MISS versus more traditional techniques have not been compared in randomized trials. Consequently, more controlled evidence is still needed to better delineate the future role and value of MISS in clinical management.
- Published
- 2017
38. Rocuronium attenuates oculocardiac reflex during squint surgery in children anesthetized with halothane and nitrous oxide.
- Author
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Karanovic, N., Jukic, M., Carev, M., Kardum, G., and Dogas, Z.
- Subjects
- *
REFLEXES , *MUSCLE relaxants , *STRABISMUS , *OPHTHALMIC surgery , *PEDIATRIC anesthesia , *HALOTHANE , *NITROUS oxide , *PEDIATRIC surgery - Abstract
The oculocardiac reflex (OCR) may be activated during squint surgery. The aim of this study was to test whether rocuronium 0.4 mg kg−1 could reduce the frequency of OCR, and also whether a single dose of succinylcholine 1 mg kg−1 could affect the frequency of OCR during anesthesia with halothane in a nitrous oxide/oxygen mixture.A total of 161 ASA I children, 3–10 years old, undergoing elective surgery of the medial rectus muscle (MRM) were randomly assigned to three groups. Group R (n = 51), received 0.4 mg kg−1 of rocuronium intravenously before endotracheal intubation. Group S (n = 58) received 1 mg kg−1 of succinylcholine. Group C (controls, n = 52) received no relaxant. Oculocardiac reflex was defined as a reduction in heart rate (HR) >= 15% and/or the appearance of any other arrhythmias, during manipulation of the MRM. Analysis of variance (anova), chi-squared, Kruskal–Wallis, and Student'st-tests were used for statistical analysis;P< 0.05 was considered statistically significant.In group R, OCR occurred in 15/51 (29%) of children, in group S in 31/58 (53%), and in group C in 23/52 (44%) (χ2 = 6.46,P = 0.049). In group R, the incidence of arrhythmias such as nodal rhythms, supraventricular and ventricular premature beats was 6%, compared with 22% in group S and 19% in group C (χ2 = 6.01,P = 0.040). However, there was no reduction in the occurrence of bradycardia (χ2 = 0.16,P = 0.924).,Rocuronium reduced the frequency of OCR, mainly by reducing the incidence of supraventricular and ventricular premature beats. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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39. Bilateral lateral rectus recession in exotropic Duane syndrome with downshoot
- Author
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Chandra Gurung, Suma Ganesh, and Pawan Shrestha
- Subjects
Orthodontics ,medicine.medical_specialty ,genetic structures ,business.industry ,medicine.medical_treatment ,General Medicine ,medicine.disease ,eye diseases ,Surgery ,Globe retraction ,Stereoscopic acuity ,03 medical and health sciences ,0302 clinical medicine ,Palpebral fissure ,Duane syndrome ,030221 ophthalmology & optometry ,medicine ,Bilateral lateral rectus recession ,Squint surgery ,sense organs ,business ,Exotropia ,Reduction (orthopedic surgery) - Abstract
Objective: To report that maximum weakening of lateral rectus muscles can improve significant exotropia in primary position, abnormal head posture, retraction, narrowing of palpebral fissure and downshoot in exotropic duannes retraction syndrome. Case: A 12-year-old boy with exotropic Duane syndrome presented with downshoot and globe retraction in attempted adduction. Squint surgery was undertaken to correct the alignment and treat the secondary aberrant movements doing maximum weakening of the lateral rectus muscles by hang- back method. At 6 months follow up visit, there was improvement in abnormal head posture, reduction of ocular deviation with downshoot and stereoacuity. Conclusion: Supramaximal recession of lateral rectus muscles can correct exotropia with down shoot in a patient with Duane retraction syndrome. Nepal J Ophthalmol 2016; 8(15): 74-77
- Published
- 2016
40. Cilioretinal artery occlusion following intranasal cocaine insufflations
- Author
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Balaji Kannan, Vijayalakshmi Balaji, Sherin Kummararaj, and Kummararaj Govindarajan
- Subjects
Pediatric traumatic cataract ,primary posterior capsulotomy ,posterior capsule opacification ,square-edge intraocular lens ,visual axis opacification ,Multifocal electroretinogram ,principal components′ ,analysis ,retinitis pigmentosa ,Behcet′s disease ,HLA-B51 ,optical coherence tomography ,macular hole ,Graves′ ophthalmopathy ,thyroid eye disease ,unilateral ,Assam ,corneal ulcer ,fusarium ,mycotic keratitis ,Antifungal sensitivity testing ,amphotericin B ,Aspergillus ,fungal keratitis ,polymerase chain reaction--single-stranded conformational polymorphism. ,Lid coloboma ,limbal dermoid ,nasopalpebral lipoma-coloboma syndrome ,Bilateral ,breast metastasis ,extraocular muscle ,Conventional dacryocystorhinostomy ,trans-canalicular laser-assisted dacryocystorhinostomy ,Eye surgery ,operation theater ,parental presence ,squint surgery ,witnessing a surgery ,Centrocecal visual field defect ,cilioretinal artery occlusion ,fluorescein angiogram ,intranasal cocaine ,Ophthalmology ,RE1-994 - Abstract
Cocaine is used to produce a euphoric effect by abusers, who may be unaware of the devastating systemic and ocular side effects of this drug. We describe the first known case of cilioretinal artery occlusion after intranasal cocaine abuse.
- Published
- 2011
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41. Intraocular Pressure Elevation Following the Use of Topical Dexamethasone Ointment After Squint Surgery.
- Author
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Ugalahi MO, Ibukun FA, Olusanya BA, and Baiyeroju AM
- Abstract
Purpose: To describe the pattern of intraocular pressure (IOP) changes after squint surgery in eyes of black Africans at the University College Hospital, Ibadan, Nigeria., Materials and Methods: This was a retrospective review of the clinical records of patients who underwent squint surgery between 2010 and 2019. Data on demographic characteristics, preoperative and postoperative intraocular pressure values, co-existing ocular pathology, type of strabismus, surgery performed, frequency and duration of postoperative topical steroid use and treatment received for elevated intraocular pressure were collected and descriptively summarised., Results: Thirty-six (39.1%) out of 92 patients who had squint surgery during the study period met study inclusion criteria. Mean age was 20.5 ± 13.6 years. All patients were administered Maxitrol® ointment postoperatively. Baseline, peak and net change in IOP were 12.9 ± 2.6 mmHg, 21.3 ± 6.8 mmHg and 8.39 ± 7.2 mmHg respectively. Thirty-one (86.1%) patients had elevation in IOP from baseline; 21 (67.7%) of these had significant IOP elevation. Topical steroid therapy was tailed off rapidly for all patients with significant IOP elevation. Twelve patients were commenced on topical IOP lowering medications, with normalization of intraocular pressure in majority of them by three months after surgery., Conclusion: Elevated intraocular pressure with the use of topical dexamethasone ointment after squint surgery was common in this study and majority of the patients had significant elevation in intraocular pressure. Close monitoring of the intraocular pressure of black patients, especially children, on topical steroid medication after squint surgery is strongly recommended., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of the West African College of Surgeons.)
- Published
- 2022
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42. Vergleich subjektiver und objektiver Parameter nach Augenmuskeloperation.
- Author
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Kaszli, F. A., Neugebauer, Antje, Berger, C., Pink, U., and Rüßmann, W.
- Abstract
Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 1997
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43. Sub-Tenon Block does not Provide Superior Postoperative Analgesia vs Intravenous Fentanyl in Pediatric Squint Surgery
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Pradeep Sharma, Vimi Rewari, Renu Sinha, Chandralekha Chandralekha, Rashmi Ramachandran, and Anjan Trikha
- Subjects
Male ,medicine.medical_specialty ,Tenon Capsule ,Ophthalmologic Surgical Procedures ,Intravenous fentanyl ,Double-Blind Method ,Humans ,Medicine ,Squint surgery ,Anesthetics, Local ,Child ,Pain Measurement ,Pain, Postoperative ,business.industry ,Lidocaine ,General Medicine ,Perioperative ,Bupivacaine ,Oculocardiac reflex ,Surgery ,Fentanyl ,Strabismus ,Ophthalmology ,Reflex, Oculocardiac ,Child, Preschool ,Anesthesia ,Sub Tenon block ,Postoperative Nausea and Vomiting ,Anesthesia, Intravenous ,Female ,Analgesia ,medicine.symptom ,business ,Anesthetics, Intravenous ,Postoperative nausea and vomiting - Abstract
Purpose We evaluated the efficacy of sub-Tenon block in decreasing perioperative pain, incidence of intraoperative oculocardiac reflex (OCR), and postoperative nausea and vomiting (PONV) in pediatric squint surgery. Methods A total of 67 children age 2-12 years, American Society of Anesthesiologists Physical Status 1 and 2, were randomized to receive either sub-Tenon block (ST) in the operative eye or 2 mcg/kg of intravenous fentanyl (F) for squint surgery after induction of general anesthesia in this double-blind study. Postoperative pain was measured by either modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) or Visual Analogue Scale (VAS). Pain in the postoperative period (up to 2 hours) was measured as the primary endpoint. Other parameters measured in the groups were intraoperative hemodynamics, postoperative modified CHEOPS or VAS at shifting, 1, 2, 6, 12, and 24 hours after surgery, incidence of intraoperative OCR, and PONV at shifting, 30 minutes, 1, 2, 6, 12, and 24 hours after surgery. Results There was no statistical difference in the postoperative pain scores in the recovery room up to 2 hours after surgery. The VAS and CHEOPS scores were not different in the groups up to 24 hours after surgery. The incidence of OCR was significantly higher in group F than group ST. The incidence of PONV was significantly higher in group F than group ST at 30 minutes and 1 hour after the surgery (41%, 47% vs 19%, 9%, respectively, pConclusions Use of sub-Tenon block does not decrease the incidence of postoperative pain significantly in children undergoing squint surgery. However, it leads to a statistically significant decrease in the incidence of intraoperative OCR and PONV in the early recovery period in these patients.
- Published
- 2014
44. Unilateral and bilateral medial rectus recession in Graves' Orbitopathy patients
- Author
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Peerooz Saeed, Roel Kloos, Yvette Braaksma-Besselink, Hinke Marijke Jellema, Maarten P. Mourits, Anneroos Schuit, Ophthalmology, RS: FHML non-thematic output, and Oogheelkunde
- Subjects
Adult ,Male ,medicine.medical_specialty ,genetic structures ,Bilateral medial rectus recession ,Ophthalmologic Surgical Procedures ,Muscle volume ,Diplopia ,Medicine ,Squint surgery ,Humans ,In patient ,Aged ,Retrospective Studies ,Vision, Binocular ,business.industry ,Large series ,Middle Aged ,eye diseases ,Surgery ,Graves Ophthalmopathy ,Strabismus ,Ophthalmology ,medicine.anatomical_structure ,Oculomotor Muscles ,Female ,medicine.symptom ,business ,Orbit (anatomy) - Abstract
PURPOSE: To evaluate the effect of uni- and bilateral medial rectus recession on squint angle and ductions in Graves' Orbitopathy (GO) patients.DESIGN: Retrospective case series.MATERIALS AND METHODS: Consecutive GO patients seen between January 2000 and March 2012 who were operated on one or both medial rectus muscles were selected for the study. Data regarding squint angle, abduction, and adduction were collected starting 3 months before surgery and 3 and 6-12 months after surgery.RESULTS: 102 patients were eligible for inclusion. Of these, 24 patients were operated on one medial rectus and 78 on two medial rectus muscles. The dose-effect response was 1.0 [-0.6-3.8]°/mm in the unilateral and 1.4 [0.2-3.0]°/mm in the bilateral group (p=0.000). In the bilateral group, the maximal abduction and adduction changed significantly (p=0.000). However, the total duction range remained unchanged (unilateral: p=0.525; bilateral: p=0.137). The extent of the preoperative abduction did not influence the dose-effect response (r=-0.234; p=0.040), nor did the muscle volume (unilateral p=0.989; bilateral p=0.397). Twenty-three patients (23%) needed additional horizontal squint surgery.CONCLUSION: In this large series of medial rectus recessions in patients with Graves' disease we found significantly lower dose-effect response ratios as compared to other studies. The amount of abduction deficit does not influence outcome.
- Published
- 2014
45. Ergebnisse und Patientenzufriedenheit von Schieloperationen mit nachjustierbaren Fäden im Langzeitverlauf
- Author
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B. Wabbels, J. Förster, and P. Roggenkämper
- Subjects
Gynecology ,Ophthalmology ,medicine.medical_specialty ,business.industry ,Long term follow up ,Medicine ,Squint surgery ,business - Abstract
Ziel: Bislang sind keine Ergebnisse zum Langzeitverlauf von Schieloperationen mit nachjustierbaren Faden veroffentlicht, obwohl diese alte Technik seit den 1970er Jahren wieder angewendet wird. Ziel dieser Studie war die Ermittlung von Patientenzufriedenheit und objektiven Untersuchungsergebnissen, die mit Studien uber nachjustierbare und konventionelle Schieloperationen verglichen werden sollten. Methoden: Anhand der Operationsberichte wurden Patienten identifiziert, die vor mehr als 10 Jahren mit einer nachjustierbaren Schieltechnik operiert worden waren. Diese Patienten wurden angeschrieben. Das Kollektiv bestand aus schwierigen Strabismusfallen, 52 % der Patienten waren voroperiert. Ergebnisse: Es konnten beantwortete Fragebogen von 113 Patienten ausgewertet werden (Rucklaufquote 41,9 % der postalisch erreichten Patienten). Bei insgesamt 34 Patienten (30 %) wurde postoperativ eine Nachjustierung zur Korrektur des Operationsergebnisses vorgenommen, bei den ubrigen wurde nur geknotet. 89,4 % bezeichneten das Knupfen/Nachjustieren als unproblematisch oder erinnerten sich nicht, die ubrigen hatten leichte subjektive Probleme. Technische Schwierigkeiten traten nicht auf. Die Patientenzufriedenheit war nach durchschnittlich 11 Jahren sehr hoch (Median 100 %). Die Reoperationsrate betrug 7 %. Fazit: Schieloperationen mit nachjustierbaren Faden erweitern das Therapiespektrum bei schwierigen Strabismusfallen und bewirken eine hohe Patientenzufriedenheit im Langzeitverlauf ohne operationstechnische Probleme.
- Published
- 2013
46. A Cost Analysis Study of Squint Surgery in A Tertiary Care Ophthalmic Hospital for Development of Users Charges
- Author
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Rajesh Sinha and Sanju Singh
- Subjects
Actual cost ,business.industry ,Total cost ,Cost analysis ,Medicine ,Squint surgery ,Optometry ,Operations management ,business ,Tertiary care - Abstract
Correspondence to : Dr. Sanju Singh E-Mail : sanjusinghdr@gmail.com Abstract Ten cases of Squint Surgery were studied to fi nd actual cost incurred on pa ent care, so as to workout the modali es to develop package system for Squint Surgery. The cost analysis for the package had been divided into ‘primary cost’ in which cost of manpower, cost of consumable, cost of linen and laundering, cost of central sterile supply department (CSSD) and manifold was included. In “overhead cost”, building cost, cost of other fi xed assets, electricity and water consump on, sanita on and air condi oning was included to fi nd total cost for deriving the package cost. Del J Ophthalmol 2012;23(4):299-303.
- Published
- 2013
47. Experiences with Medial Decompression of the Orbit
- Author
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Smith, Vernon H., The Orbital Centre of the Amsterdam University Eye Hospital, The Netherlands Ophthalmic Research Institute, The Netherlands Ophthalmological Society, and The New York Eye and Ear Infirmary
- Published
- 1978
- Full Text
- View/download PDF
48. The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy
- Author
-
Bartalena, Luigi, Baldeschi, Lelio, Boboridis, Kostas, Eckstein, Anja, Kahaly, George J, Marcocci, Claudio, Perros, Petros, Salvi, Mario, Wiersinga, Wilmar M, Adamidou, Fotini, Anagnostis, Panagiotis, Ayvaz, Goksun, Azzolini, Claudio, Boschi, Antonella, Bournaud, Claire, Clarke, Lucy, Currò, Nicola, Daumerie, Chantal, Dayan, Colin, Führer, Dagmar, Konuk, Onur, Marinò, Michele, Morris, Daniel, Nardi, Marco, Pearce, Simon, Pitz, Susanne, Rudovsky, Gottfried, Vannucchi, Guia, Vardanian, Christine, von Arx, Georg, Other departments, and Endocrinology
- Subjects
medicine.medical_specialty ,Pediatrics ,Cyclosporine ,Eyelid surgery ,Glucocorticoids ,Graves' orbitopathy ,Orbital decompression ,Orbital radiotherapy ,Rituximab ,Selenium ,Squint surgery ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Medizin ,030209 endocrinology & metabolism ,Disease ,Guidelines ,03 medical and health sciences ,Endocrinology ,0302 clinical medicine ,Quality of life ,medicine ,business.industry ,Cumulative dose ,Thyroid ,eye diseases ,Surgery ,Diabetes and Metabolism ,Artificial tears ,medicine.anatomical_structure ,Methylprednisolone ,030221 ophthalmology & optometry ,business ,Watchful waiting ,medicine.drug - Abstract
Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mech anisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment. (C) 2016 European Thyroid Association Published by S. Karger AG, Basel
- Published
- 2016
49. Surgical outcome of single-staged three horizontal muscles squint surgery for extra-large angle exotropia
- Author
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W W K Yip, Flora H S Lau, C B O Yu, Dennis S.C. Lam, and Dorothy S. P. Fan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,genetic structures ,Eye disease ,Ophthalmologic Surgical Procedures ,Outcome (game theory) ,Young Adult ,Ophthalmology ,medicine ,Humans ,Squint surgery ,Prospective Studies ,Child ,Eye Movement Measurements ,Aged ,business.industry ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,Oculomotor Muscles ,Exotropia ,Female ,sense organs ,business ,Follow-Up Studies ,Strabismus surgery - Abstract
To report the surgical outcomes of 24 patients undergoing single-staged three horizontal muscles squint surgery for extra-large angle exotropia.Prospective case series of 24 consecutive patients with primary exotropia60 prism diopters (PD) at distant and underwent single-staged three horizontal muscles squint surgery from 2003 to 2006. Surgery consisted of bilateral lateral rectus recession of 9.0 mm for 50 PD exotropic correction. For every 5 PD remaining angle exceeding 50 PD, we additionally performed 1.0 mm of unilateral medial rectus resection. The mean follow-up period was 15.8 months (range 6.0-38.0 months; SD 9.5 months).The mean age at surgery was 31.2 years old (range 7-78 years old, SD 18.2 years old). The mean distant preoperative deviation was 71.3 PD (range 60-85 PD, SD 7.7 PD). No limitation of eye movement or diplopia was found. The success rate was higher in the intermittent group (88.2%) than the constant group (42.9%) (P=0.02) and in cases with preoperative deviation of80 PD (84.2%) compared with those with deviationor=80 PD (40.0%) (P=0.042).Measurement of preoperative deviation and the surgery for extra-large angle exotropia made management of this condition difficult. Single-staged three horizontal muscles squint surgery can be one of the options. Further researches on management of exotropia of80 PD are warranted.
- Published
- 2010
50. Keratopigmentation combined with strabismus surgery to restore cosmesis in eyes with disabling corneal scarring and squint.
- Author
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Balgos JD, Amesty MA, Rodriguez AE, Al-Shymali O, Abumustafa S, and Alio JL
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Cicatrix diagnosis, Cicatrix etiology, Corneal Diseases diagnosis, Corneal Diseases etiology, Female, Humans, Male, Middle Aged, Postoperative Complications diagnosis, Retrospective Studies, Treatment Outcome, Young Adult, Cicatrix prevention & control, Cornea diagnostic imaging, Corneal Diseases prevention & control, Ophthalmologic Surgical Procedures methods, Postoperative Complications prevention & control, Strabismus surgery, Tattooing methods
- Abstract
Background: Therapeutic corneal pigmentation has modernly evolved into different sophisticated techniques to camouflage cosmetically disabling corneal opacities and scars with good reported outcomes. Blind eyes frequently suffer from strabismus which further deteriorates the cosmesis of the patient. Combined keratopigmentation (KTPG) with strabismus surgery may be an option for these patients., Methods: A total of 72 consecutive patients were retrospectively reviewed in this investigation. Main outcome measures were postoperative residual squint, and cosmesis evaluated by an independent observer, patient satisfaction, reoperation rates for KTPG and squint, and complications., Results: A total of 72 consecutive patients and 73 eyes that underwent KTPG and strabismus surgery were included in this study. Mean follow-up time was 2.5±3 years. Patient age ranged from 5 to 83 years, with 93% having visual acuity worse than 0.1. 14 eyes (24.5%) underwent repeated KTPG, 24 (42.1%) had repeated strabismus surgery. 14 patients (19.4%) had a repeat muscle surgery, although 55 (76.4%) of the 72 patients achieved orthotropia or had deviations within 10 prism dioptres at the end of the follow-up period. Corneal microperforation was encountered in two (2.8%) patients and conjunctival staining in 10 eyes. Cosmesis was good for all patients. Patients who required repeat KTPG or strabismus surgery, or those in whom orthotropia was not totally restored, considered their cosmetic appearance sufficiently improved., Conclusion: Corneal KTPG combined with strabismus surgery provides good cosmesis for patients with corneal scarring and strabismus with minimal complications. Reoperation rates are relatively high in the short term to accomplish an optimal cosmetic result., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
- Full Text
- View/download PDF
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