The differential influence of fixation and directed visual attention on reaction times of goal-directed saccades and especially on the occurrence of express saccades was investigated. In all the experiments the subjects were instructed first to keep their direction of gaze at the center of a translucent screen with or without a central fixation point. When a new stimulus appeared, the subjects had to look at it as soon as possible. In some control experiments the subjects had to direct their gaze to the screen center and simultaneously direct their attention to a peripheral light spot before the target for the saccade appeared. Many express saccades occurred when either active fixation of a central fixation point or attention directed to a peripheral visual target (regardless of its position) was interrupted 200 ms before the target for the saccade appeared. Express saccades were almost completely abolished in the presence of fixation and/or directed visual attention at the moment in which the saccade target appeared. We conclude that express saccades occur if visual attention has already been released at the moment when the target for the saccade appears. This disengagement needs some time which adds to the reaction time.

SOMD and MAMD allow achievement of significant improvement of pain and neurological deficits in patients with lumbar disc herniations. Differences in operative time, blood loss, and complication rates were statistically not significant in MAMD compared with SOMD, indicating that, at least in lumbar disc surgery, minimal access trocar techniques are a viable alternative to standard spinal approaches.

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