Journal of Pediatric Ophthalmology & Strabismus最新文献

Purpose: To report long-term motor and sensory outcomes after unilateral lateral rectus recession-medial rectus resection for infantile constant exotropia.

Methods: The medical records of patients who had undergone unilateral lateral rectus recession-medial rectus resection for infantile constant exotropia who were followed up postoperatively for a minimum of 4 years were reviewed retrospectively.

Results: A total of 20 patients were included. The mean age at surgery was 3.21 ± 1.54 years (range: 1.25 to 6.00 years). The mean duration of exodeviation was 2.99 ± 1.61 years (range: 9 months to 6 years). The mean angle of exodeviation was 70.1 ± 20.9 prism diopters (PD) (range: 35 to 90 PD). The median postoperative follow-up was 9.1 years (range: 4 to 24 years). Overall, 12 patients (60%) had surgical success at their last follow-up visit. Age at first surgery, cycloplegic refraction, strabismus duration, preoperative angle of deviation, presence of amblyopia, and the number of exotropia surgeries did not predict motor outcome after surgery. At the last follow-up visit, 20% of patients had residual exotropia and 15% had recurrent exotropia. Peripheral binocular single vision was achieved in 25% of patients and stereopsis in none. Age at first surgery, strabismus duration, and surgical outcome had no effect on sensory outcome.

Conclusions: In this study, 60% of patients achieved a successful long-term motor outcome and 25% achieved peripheral binocular single vision after unilateral recession-resection for infantile constant exotropia. Stereopsis outcome was nil. Age at surgery and duration of strabismus had no effect on motor and sensory outcomes. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].

Purpose: To investigate the ophthalmic complications associated with spina bifida myelomeningocele (SBM) in Irish children and to evaluate the impact of spinal lesion levels and shunt status on visual outcomes.

Methods: A retrospective audit was conducted on 129 children with SBM, examining visual acuity, refractive errors, strabismus, papilledema, optic atrophy, and cortical visual impairment (CVI). The median age of participants was 6.9 years (interquartile range [IQR] = 7.07), comprising 69 females (53.5%) and 60 males (46.5%). Data were analyzed using chi-square and Kruskal-Wallis tests to assess associations between spinal lesion levels, shunt status, and visual outcomes.

Results: The majority of lesions were lumbar (60.47%), followed by sacral (20.16%), thoracic (18.60%), and occipital (0.78%). Ventriculoperitoneal shunts were present in 67.44% of participants. Most children had good visual acuity, with visual impairment observed in 18.2%. Significant refractive errors were present in 40.8% of cases, whereas strabismus was observed in 33.3% of patients, predominantly esotropia. Papilledema, optic atrophy, and CVI were present in 12.4%, 5.4%, and 4.7% of participants. Higher spinal lesion levels were significantly associated with worse visual acuity (P = .019), whereas ventriculoperitoneal shunt status was significantly associated with papilledema (P = .034) and significant refractive errors (P = .019). No significant associations were found for strabismus, optic atrophy, or CVI.

Conclusions: Ophthalmic complications such as refractive errors, strabismus, and visual impairment are common in children with SBM. The authors found that higher spinal lesions were associated with worse visual acuity. Shunt placement was also associated with a history of papilledema and higher rates of significant refractive error. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].

Purpose: To investigate the effects of recession or re-section surgery on PAX 7 positive satellite cells of the extraocular muscle (EOM) in rabbits.

Methods: A total of 20 rabbits (40 eyes) were included in this study. The superior rectus muscle of the right eye was either recessed or resected. Recession surgeries were performed at a distance of 5 mm (5 rabbits) and 10 mm (5 rabbits) from the original insertion, whereas resection surgeries were performed at a distance of 4 mm (5 rabbits) and 8 mm (5 rabbits). The superior rectus (operated muscle), inferior rectus (antagonist muscle), and superior rectus of the contralateral eye (control) were extracted 4 weeks after surgery. The number of PAX7 positive satellite cells was analyzed using immunohistochemistry.

Results: The number of PAX7 positive satellite cells in the operated and antagonist muscles was higher than that in the control muscle after all surgeries (P < .05, all). The number of PAX7 positive satellite cells in operated and antagonist muscles after resection surgery was higher than that after recession surgery (P < .05, all). Howerver, there were no significant differences of PAX7 positive satellite cells in operated and antagonist muscle in recession and resection surgery according to the surgical amount (P > .05, all).

Conclusions: PAX7 positive satellite cells in the operated and antagonist muscles showed an increase after resection surgery compared to recession surgery. This suggests that the extent of EOM regeneration may vary depending on the surgical method used for strabismus surgery. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].

Purpose: To report the results of botulinum toxin A (BTA)-augmented bilateral recession or monocular recession/resection surgery in a case series of patients with large-angle strabismus and review the relevant literature.

Methods: This retrospective study reviewed the medical records of 24 patients treated with BTA-augmented strabismus surgery for large-angle horizontal strabismus (55 prism diopters or greater) with a minimum 6-month follow-up. Patients underwent unilateral recession-resection or bilateral rectus muscle recession surgery with intraoperative BTA injection into the recessed muscle(s). Main outcome measures were postoperative angle of deviation and success rate, defined as a final deviation of 10 prism diopters or less.

Results: Of 24 patients (20 esotropia, 4 exotropia), the mean age was 9.2 years (range: 1 to 64 years). Mean preoperative deviation was 61.2 prism diopters for esotropia and 66.2 prism diopters for exotropia. Mean final postoperative deviation was 6.6 prism diopters for esotropia and 14.5 prism diopters for exotropia. Successful outcomes were achieved in 75% of patients with esotropia and 50% of patients with exotropia.

Conclusions: BTA augmentation of conventional strabismus surgery dosages is a promising approach for managing large-angle strabismus, particularly esotropia. Optimal patient selection and follow-up are needed to maximize surgical success rates. [J Pediatr Ophthalmol Strabismus. 2025;62(1):5-11.].

Purpose: To analyze pediatric ophthalmology-related information on Instagram (Meta Platforms, Inc).

Methods: A cross-sectional study queried 112 common eye terms and conditions from the American Association for Pediatric Ophthalmology and Strabismus website as hashtags on Instagram. A categorical classification system was used to analyze the top 9 posts per hashtag for likes, comments, views, and engagement level ratio (ELR). Posts were further characterized by author and content type.

Results: Analysis of the top 901 posts that met our inclusion criteria revealed a cumulative 424,608 likes, 15,793 comments, and 2,873,042 views. Authors had a total of 76,076,455 followers. Patients/families created the greatest number of posts (37.6%), followed by companies (20.2%), other (14.9%), medical organizations (12.3%), international ophthalmologists (6.1%), optometrists (5.9%), and American Board of Ophthalmology-certified ophthalmologists (3.0%). Content was mostly patient experience (42.4%), followed by educational (29.7%), self-promotional (13.5%), other (10.5%), and career-related (3.8%). Companies authored the highest number of educational posts (23.5%), followed by medical institutions (20.9%), other (19.4%), international ophthalmologists (13.8%), optometrists (13.4%), and American Board of Ophthalmology-certified ophthalmologists (4.5%) and patients (4.5%).

Conclusions: Although pediatric ophthalmology content presented by board-certified ophthalmology Instagram authors had a greater number of followers than most other author categories, ophthalmologist authors on Instagram are still underrepresented. Additional research is warranted to help promote ophthalmologist-authored posts. [J Pediatr Ophthalmol Strabismus. 2025;62(1):50-56.].

Congenital eyelid imbrication syndrome is rare and ranges from mild overriding of the upper eyelid on the lower eyelid to manually irreversible total upper eyelid eversion. The authors report two cases. One resolved with temporary tarsorraphies. The more severe case did not resolve and required bilateral upper eyelid lateral tarsal strip surgeries. [J Pediatr Ophthalmol Strabismus. 2025;62(1):e1-e3.].

Purpose: To evaluate "beezin," a social media trend that involves applying Burt's Bees Lip Balm to the eyelids to induce intoxication, which has the potential to cause ocular problems.

Methods: Researchers identified the top TikTok videos about beezin using the search terms "beezing," "beezin," "burtsbees," "Burt's Bees on eyelids," and "burtsbeeschallenge." Researchers watched each video and recorded key information. Descriptive statistics were calculated.

Results: Sixty top videos were included in the analysis; they had more than 158 million views and more than 11 million likes. More than half (n = 37, 61%) portrayed the trend positively, 11 (18%) portrayed the trend negatively, and 12 (20%) took a neutral stance on the trend. None of the videos were created by a health care provider.

Conclusions: Beezin is a viral social media trend that may cause ocular problems. There is a need for factual TikTok content to combat the trend. Health care providers should consider beezin when adolescent patients present with contact dermatitis, conjunctivitis, or other possible sequelae of beezin. [J Pediatr Ophthalmol Strabismus. 2025;62(1):39-41.].

Purpose: To compare the effectiveness of two surgical approaches in the management of exotropic Duane retraction syndrome (DRS) cases with significant overshoot and retraction.

Methods: A retrospective analysis was conducted on patients with exotropic DRS who experienced significant overshoot and globe retraction. Patients with incomplete medical records or previous strabismus surgery were excluded. Overshoot and retraction were graded on a scale of 1 to 3. Surgical outcomes were assessed based on exotropia correction, head turn correction, leash correction, and globe retraction correction.

Results: Twenty-one patients with unilateral type III exotropic DRS were included in the study. The Y-split recession of the lateral rectus muscle (LR) group comprised 13 patients who underwent Y-split recession of the LR alone and the Y-split recession of LR + ipsilateral MR recession group consisted of 8 patients who underwent Y-split LR recession combined with medial rectus (MR) recession. The average of exotropia and head turn correction was higher in the Y-split recession of LR group (15.76 prism diopters [PD], 18.46°) compared with the Y-split recession of LR + ipsilateral MR recession group (11.12 PD, 12.12°). On the other hand, the Y-split recession of the LR + ipsilateral MR recession group exhibited higher mean correction grades for leash and retraction (2.63 and 2.5, respectively) compared to the Y-split recession of LR group (2.31 and 1.92, respectively).

Conclusions: Both surgical approaches showed promising results in managing exotropic DRS cases with significant overshoot and retraction. Y-split LR recession combined with MR recession could possibly be a better surgical option in cases where severe retraction and overshoot are the main issues. Further investigations with larger sample sizes are necessary to validate these findings and determine the optimal surgical approach. [J Pediatr Ophthalmol Strabismus. 2025;62(1):67-74.].