Innovative techniques for the treatment of adult strabismus

Pineles, Stacy L.; Chang, Melinda Y.; Holmes, Jonathan M.; Kekunnaya, Ramesh; Özkan, Seyhan B.; Velez, Federico G.

doi:10.1016/j.jaapos.2018.10.018

Cited by 9 publications

(8 citation statements)

References 18 publications

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“…Clinical studies have confirmed that, after surgery, the convergence center function is still reduced in CI-IXT patients, and constant exotropia or even complete loss of stereopsis may occur in severe cases in case of no aggressive interventions [17,18]. Currently, the slanted lateral rectus recession is a common surgical practice for treating CI-IXT, which modulates the visual axis of both the eyes to maintain balance and then restore the normal visual function of the affected children.…”

Section: Discussionmentioning

confidence: 99%

Effect of Applying Binocular Visual Training after Slanted Lateral Rectus Recession on Orthophoric Rate and Binocular Visual Function Recovery on Patients with Convergence Insufficiency-Type Intermittent Exotropia

Dai

Sun

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To explore the effect of applying binocular visual training after slanted lateral rectus recession on orthophoric rate and binocular visual function recovery on patients with convergence insufficiency-type intermittent exotropia (CI-IXT). Methods. A total of 76 CI-IXT child patients treated at the Strabismus and Pediatric Ophthalmology Department of our hospital from June 2019 to June 2020 were selected as the research objects, and those who met the inclusion criteria were equally divided into group A (63 eyes) and group B (61 eyes) according to the sealed envelope randomization. All child patients accepted the slanted lateral rectus recession, and after that, those in group A accepted the binocular visual training and those in group B accepted the conventional visual function rehabilitation training, so as to compare their position of eye, the best corrected visual acuity, etc., after training for statistical analysis. Results. Compared with group B after one month of surgery, group A had significantly less patients with grade I binocular vision function ( P < 0.001) and more patients with grade II and III vision function ( P < 0.05); between group A and group B, after 3 months and 6 months of treatment, the number of eyes with normal stereoscopic vision was significantly higher in group A ( P < 0.05); at 15 days, 1 month, 3 months, and 6 months of treatment, the visual strain scores of group A were significantly lower ( P < 0.001); after treatment, the number of orthophoria eyes was significantly higher in group A ( P < 0.001), while the numbers of overcorrected eyes and undercorrected eyes were significantly higher in group B ( P < 0.001); and the total incidence rate of adverse reactions was significantly lower in group A ( P < 0.05). Conclusion. Applying binocular visual training to child patients with CI-IXT after slanted lateral rectus recession can promote the recovery of binocular vision and ensure higher safety, and further study will help to establish a better solution for the affected children.

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Section: Discussionmentioning

confidence: 99%

Effect of Applying Binocular Visual Training after Slanted Lateral Rectus Recession on Orthophoric Rate and Binocular Visual Function Recovery on Patients with Convergence Insufficiency-Type Intermittent Exotropia

Dai

Sun

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Muscle transplantation combined with recession and resection of the medial or lateral rectus muscle is highly effective for big-angle esotropia (>70∆), significant exotropia, and abducens nerve palsy with good abduction. [ 14 ] The long-term effects of muscle transplantation in 22 patients were documented by Jethani. Esotropia of >85∆ was present in all patients, and the average follow-up time was 2 years.…”

Section: Discussionmentioning

confidence: 99%

Surgery for longer duration supranuclear ophthalmoplegia secondary to brain stem cavernoma: A case report and literature review

Sheng,

Ge,

Zhu

2024

Medicine

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Background: Previous reports revealed that patients with acquired paralytic strabismus caused by central nervous system diseases are primarily affected by the etiology and treatment of the condition. Strabismus correction for these acquired paralytic strabismus should be performed as soon as the primary disease has been stabilized for 6 months in order to archive a favorable surgical outcome. Case: We followed an infrequent case of longer-lasting supranuclear ophthalmoplegia secondary to brain stem cavernoma. Observation: A 25-year-old Chinese Han female developed aberrant head posture and ipsilateral conjugate gaze palsies 8 years after the first brainstem hemorrhage caused by pontine cavernoma. The patient was diagnosed with supranuclear ophthalmic palsy and brain stem cavernoma after surgery. A resection–recession procedure along with a rectus muscle transposition was performed. The patient’s abnormal head position disappeared, with a normal primary position. Conclusion: Resection–recession procedures combined with rectus muscle transposition works very well for longer duration large-angle strabismus caused by brain stem cavernoma.

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“…However, this table did not extend beyond correction for 90 PD; thus corrections greater than this value were further developed by the current authors. [ 20 ] Exclusion criteria were previous squint surgery and previous cataract or glaucoma surgery.…”

Section: Methodsmentioning

confidence: 99%

Extraocular Muscle Transplantation Surgery for Primary Treatment of Extra Large-angle Squint

Adio,

Ezisi,

Nkanga

2024

JOVR

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Purpose: Large-angle horizontal ocular deviations will commonly require bilateral surgery to correct the primary ocular deviation. However, considering the need for full correction with one surgical procedure and patients’ reluctance to be operated on the good eye, such large horizontal ocular deviations may be managed with true muscle transplantation. The authors present a case series of patients who underwent this procedure and develop a surgical table to guide management. Methods: Patients with horizontal squints measuring 80 prism diopters (PD) or larger in all age groups who underwent extraocular muscle transplantation surgery between January 2019 and June 2022 in Nigeria were included. Preoperative deviation of the squint, sensory evaluation, surgical dosage, and outcomes were documented. Part of the resected muscle was transplanted to give additional recession in the antagonist muscle. Success was defined as deviation corrected by 60% or more or postoperative ocular alignment within 10 PD or less, six weeks postoperatively. Results: Fourteen patients with extra-large-angle strabismus were operated. Male/female ratio was 0.6:1. Mean preoperative deviation of 89.6 ± 9.3 collapsed to 6.6 ± 1.8 PD at six weeks and continued to improve to a mean deviation of 2.5 PD at six months postoperatively. When the subgroup of patients who were <18 years were analyzed, the outcome was equally successful; preoperative deviation of 89.4 PD collapsed to 1.4 PD, six months postoperatively. There were equal success rates when those with sensory strabismus were compared with those with binocular vision; preoperative deviation of 92.5 PD in the sensory group and 88.5 PD in the binocular group collapsed to 5.9 PD and 1 PD, respectively, six months after surgery. Conclusion: A viable alternative for treating extra-large-angle strabismus in adults and children in developing countries was described with good postoperative outcome. In addition, a new expanded surgical dosage table for muscle transplantation surgery corrections of up to 130 PD was developed.

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Innovative techniques for the treatment of adult strabismus

Cited by 9 publications

References 18 publications

Effect of Applying Binocular Visual Training after Slanted Lateral Rectus Recession on Orthophoric Rate and Binocular Visual Function Recovery on Patients with Convergence Insufficiency-Type Intermittent Exotropia

Effect of Applying Binocular Visual Training after Slanted Lateral Rectus Recession on Orthophoric Rate and Binocular Visual Function Recovery on Patients with Convergence Insufficiency-Type Intermittent Exotropia

Surgery for longer duration supranuclear ophthalmoplegia secondary to brain stem cavernoma: A case report and literature review

Extraocular Muscle Transplantation Surgery for Primary Treatment of Extra Large-angle Squint

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