Korrektur horizontaler Schielwinkel nach Dekompressionsoperation bei Patienten mit endokriner Orbitopathie – Vergleich von Sehnenverlängerung und einfacher Rücklagerung des M. rectus medialis

Oeverhaus, Michael; Fischer, M. C.; Schlüter, A; Esser, Joachim; Eckstein, Anja

doi:10.1055/a-0719-5354

Cited by 5 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study tendon elongation with bovine pericardium was considered for a heterogeneous group of patients which was unlikely to show satisfying results with conventional eye muscle surgery only. Thereby the spectrum of indications for this special procedure has been broadened [13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Unilateral recessions had a mean effect of 1.2 ± 0.4°/mm (2.1Δ/mm), bilateral of 1.0 ± 0.3°/mm (1.8Δ/mm). Unilateral medial rectus muscle tendon elongation with simultaneous simple recession of the medial rectus muscle on the partner eye had a mean effect of 0.92 ± 0.3°/mm (1.6Δ/mm) and bilateral tendon elongation of 0.87 ± 0.3°/mm (1.5Δ/mm) [15]. Interestingly, Table 2 Patients with vertical rectus muscle surgery to improve a vertical angle of squint and long-term follow-up: full extent of deviation in primary position (in prism diopters, absolute values) preoperatively, at the first postoperative day, in the long term, and improvement ( the effect was stronger for inferior rectus muscle than for medial rectus muscle tendon elongation.…”

Section: Surgical Effectmentioning

confidence: 96%

“…Oeverhaus et al described the non-absorbable sutures of the implant to penetrate the conjunctiva over time. Therefore, they recommended using absorbable sutures [15]. Awadein et al reported a high incidence of over-effect for large hangback medial rectus muscle recessions with absorbable sutures.…”

Section: Biocompatibilitymentioning

confidence: 99%

“…In 2011, Esser and Eckstein were the first to publish their experiences (dating back to 1996) with bovine pericardium (Tutopatch®) in eye muscle surgery for tendon elongation in patients with Graves' orbitopathy [13,14]. They reported it to be a safe surgical method which also showed satisfying longterm results in correction of large angles of squint in this restrictive disorder [14,15]. Further, bovine pericardium was reported to be replaced by tendon-like tissue over time [13,14,16].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Tendon elongation with bovine pericardium in strabismus surgery—indications beyond Graves’ orbitopathy

Hedergott

Pink-Theofylaktopoulos

Neugebauer

2020

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Background For some patients with complex ocular motility disorders, conventional strabismus surgery is insufficient. Surgery with tendon elongation allows correction of larger angles and maintains a sufficient arc of contact for rectus muscles. This study reports results for tendon elongation with bovine pericardium (Tutopatch®) in indications other than Graves’ orbitopathy in which it is already widely used. Methods We reviewed the records of all patients who underwent surgery with Tutopatch® in our institution. Angles of squint and head postures were analyzed preoperatively, on the first postoperative day, and in the long term (median 9 weeks after the operation). Patients with Graves’ orbitopathy were excluded. Results From 2011 to 2018, the procedures on 58 eyes of 54 patients (35 females, median age 35 years (3–75)) met the inclusion criteria. Horizontal rectus muscle surgery (53 eyes) was conducted on patients with residual strabismus (13), Duane’s retraction syndrome with eso- (type I: 16)/exodeviation (type II: 2, type III: 1), 6th (7)/3rd nerve palsy (7), Möbius syndrome (2), congenital fibrosis of the extraocular muscles type 3A (CFEOM3A, TUBB3 mutation) (4), and orbital apex syndrome (1). Vertical rectus muscle surgery (5 eyes) was conducted on patients with myasthenia (1), vertical tropia after orbital floor fracture (1), CFEOM1 (2), and Parry-Romberg syndrome (1). 42 eyes had prior eye muscle surgery (1–5 procedures, median 1). Out of 45 patients with postoperative long-term data, 43 showed an angle reduction. Fifty-one percent had an angle of 10Δ (prism diopter) or less, one had a significant over-effect, and 10 had revision surgery. For the heterogeneous group of residual eso- and exotropias, the median absolute horizontal angle was reduced from 35Δ (16 to 45Δ) to 9Δ (0 to 40Δ), for Duane’s retraction syndrome from 27.5Δ (9 to 40Δ) to 7Δ (0 to 40Δ), and for sixth and third nerve palsies from 43Δ (20 to 75Δ) to 18Δ (4 to 40Δ). For 3 patients with vertical rectus muscle surgery, the median absolute vertical angle was reduced from 30Δ (20 to 45Δ) to 4Δ (1 to 22Δ). The motility range was shifted in the direction contrary to the elongated muscle in all subgroups. A considerable reduction of the excursion into the field of action of the elongated muscle had to be registered. Conclusions Strabismus surgery with bovine pericardium introduces new surgical options for complicated revisions and for rare and complex oculomotor dysfunctions. Yet, it has to be recognized that this type of surgery aiming at maximum effects, despite preservation or restitution of the arc of contact, leads to reduction of the excursion into the field of action of the elongated muscle. Furthermore, dose finding can be difficult depending on the underlying pathology and more than one intervention might be necessary for optimal results.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Surgical Effectmentioning

confidence: 96%

Section: Biocompatibilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Tendon elongation with bovine pericardium in strabismus surgery—indications beyond Graves’ orbitopathy

Hedergott

Pink-Theofylaktopoulos

Neugebauer

2020

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

show abstract

“…B. für die endokrine Orbitopathie erarbeitet, die gezeigt haben, dass der Effekt einer Rücklagerung für jeden Muskel gesondert betrachtet werden muss, da beispielsweise die Rücklagerung des M. rectus inferior um 1 mm einen deutlich größeren Effekt auf den Vertikalschielwinkel hat als die gleiche Rücklagerung des M. rectus medialis auf den Horizontalschielwinkel. Er-schwerend kommt hinzu, dass diese Dosierungen nach vorangegangener knöcherner Orbitadekompression wieder andere sind als bei primären, entzündungsbedingten Muskelfibrosierungen, weshalb hier eine Gegenüberstellung beider Situationen dem Operateur eine gute Dosierungsanleitung geben kann [3].…”

unclassified