Prinzip Gegenparese: M.-obliquus-inferior-Rücklagerung bei Patienten mit endokriner Orbitopathie

Eckstein, Anja; Raczynski, Susanne; Dekowski, Dirk; Esser, Joachim

doi:10.1055/s-0035-1558152

Cited by 1 publication

(4 citation statements)

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“…Another approach, large inferior recessions and tendon elongations can be associated with incyclotorsion. Therefore, they should be considered preferably in cases with excyclotorsions (Eckstein et al 2012;Jellema et al 2012). When using the combined approach, the simultaneously performed contralateral superior recession can neutralize this incyclotorsion.…”

Section: Surgical Resultsmentioning

confidence: 99%

“…De Hoog et al have shown that this condition occurs with ipsilateral superior rectus muscle fibrosis (De Hoog et al 2010). In this condition, an inferior oblique recession in the contralateral eye (Eckstein et al 2015) or an asymmetrical inferior rectus recession would be a better option (Jellema et al 2012).…”

Section: Surgical Resultsmentioning

confidence: 99%

“…Therefore, they should be considered preferably in cases with excyclotorsions (Eckstein et al. 2012; Jellema et al. 2012).…”

Section: Discussionmentioning

confidence: 99%

“…In this condition, an inferior oblique recession in the contralateral eye (Eckstein et al. 2015) or an asymmetrical inferior rectus recession would be a better option (Jellema et al. 2012).…”

Section: Discussionmentioning

confidence: 99%

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Primary and secondary superior rectus recessions to correct vertical deviations in Graves’ orbitopathy patients

Eckstein

Oeverhaus

Dekowski

et al. 2021

Acta Ophthalmologica

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Purpose: Patients with vertical strabismus and consecutive diplopia due to Graves' orbitopathy (GO) might need recession of the rectus superior muscle. The aim of this retrospective analysis is to provide dose-effect values and motility analysis for these patients. Methods: Dose-effect relations (deviation reduction in primary position per amount of recession in mm), monocular excursions and size of the field of binocular single vision (BSV) were evaluated in three different groups of patients. Group 1 (n = 33) patients with primary fibrosis of superior rectus muscle undergoing recession of the ipsilateral rectus superior, Group 2 (n = 14) superior rectus muscle recession after recession of inferior rectus on the contralateral eye and Group 3 (n = 15) simultaneous ipsilateral superior rectus recession and contralateral inferior rectus muscle recession. Surgery was performed using the dose-effect for inferior rectus recession of 4 prism dioptre (PD, D ) reduction/per mm recession and the intraoperative traction test. Results: Restoration of BSV in the central 20°of gaze could be reached in 88%, 79% and 67% of patients in the three groups, respectively. Restoration of BSV in downgaze (up to 30°) was a little less successful, 79%, 57% and 53%, respectively. The median dose-effect was 3.2 D reduction/mm recession in Group 1 (Spearman correlation r = 0.75, p < 0.0001) and 3.3 D /mm in Group 2 (n.s.) and 4 D /mm in Group 3 (r = 0.67, p = 0.016). The basis for the improvement was the symmetrization of ductions. Conclusion: If superior rectus recession is necessary in GO, higher dosing around 3 D reduction/per mm recession should be applied. In case of large deviations, combined vertical surgery (inferior rectus and superior rectus contralateral) is required and reasonable (low cyclotorsion). Single-step or two-step procedures lead to similar results.

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Section: Surgical Resultsmentioning

confidence: 99%