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Surgical dose-responses of bilateral medial rectus muscle recession in acute acquired comitant esotropia compared to infantile esotropia.
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-10 DOI: 10.1080/09273972.2025.2474430
Worawalun Honglertnapakul, Watcharakorn Lertduailap, Kidakarn Meethongkam, Parnchat Pukrushpan

Objective: To determine the surgical dose-responses of the bilateral medial rectus recession in acute acquired comitant esotropia (AACE) compared to infantile esotropia. Design: Retrospective study. Methods: The medical records of patients diagnosed with AACE and infantile esotropia who underwent bilateral medial rectus muscle recession (BMRR) were reviewed. Patient characteristics, ocular examinations and surgical data were collected. A motor success was defined as horizontal deviation within 10 prism diopters (PD) of ortho, and a sensory success was defined as no diplopia at 6 months after the surgery. Results: A total of 114 patients were included. There were 39 patients with AACE [median (Q1-Q3) age was 20 (15-25) years, 56% was female] and 75 patients with infantile esotropia [median (Q1-Q3) age was 3 (1-5) years, 56% was female]. The surgical dose-responses of BMRR in AACE at distance and near were 2.67 PD/mm (r2 = 22.8%) and 3.48 PD/mm (r2 = 32.9%), respectively. The surgical dose-responses of BMRR in infantile esotropia at distance and near were 3.91 PD/mm (r2 = 17.8%) and 4.64 PD/mm (r2 = 18.0%), respectively. Seventy-four percent of patients with AACE and 63% of patients with infantile esotropia achieved a motor success. Eighty-five percent of patients with AACE achieved a sensory success. The postoperative drift at distance and at near was not significant in both groups [AACE 0 PD (-6 to 10), p = .26 and 2 PD (-2 to 6), p = .44; infantile esotropia [8 PD (0-14), p = .12 and 4 PD (0-10), p = .22]. Conclusions: The BMRR in infantile esotropia had a larger surgical dose-response than in AACE. In both groups, the surgical dose-responses at near were greater than at distance. There was no significant postoperative drift at distance and at near in both groups.

{"title":"Surgical dose-responses of bilateral medial rectus muscle recession in acute acquired comitant esotropia compared to infantile esotropia.","authors":"Worawalun Honglertnapakul, Watcharakorn Lertduailap, Kidakarn Meethongkam, Parnchat Pukrushpan","doi":"10.1080/09273972.2025.2474430","DOIUrl":"https://doi.org/10.1080/09273972.2025.2474430","url":null,"abstract":"<p><p><i>Objective</i>: To determine the surgical dose-responses of the bilateral medial rectus recession in acute acquired comitant esotropia (AACE) compared to infantile esotropia. <i>Design</i>: Retrospective study. <i>Methods</i>: The medical records of patients diagnosed with AACE and infantile esotropia who underwent bilateral medial rectus muscle recession (BMRR) were reviewed. Patient characteristics, ocular examinations and surgical data were collected. A motor success was defined as horizontal deviation within 10 prism diopters (PD) of ortho, and a sensory success was defined as no diplopia at 6 months after the surgery. <i>Results</i>: A total of 114 patients were included. There were 39 patients with AACE [median (Q1-Q3) age was 20 (15-25) years, 56% was female] and 75 patients with infantile esotropia [median (Q1-Q3) age was 3 (1-5) years, 56% was female]. The surgical dose-responses of BMRR in AACE at distance and near were 2.67 PD/mm (r<sup>2</sup> = 22.8%) and 3.48 PD/mm (r<sup>2</sup> = 32.9%), respectively. The surgical dose-responses of BMRR in infantile esotropia at distance and near were 3.91 PD/mm (r<sup>2</sup> = 17.8%) and 4.64 PD/mm (r<sup>2</sup> = 18.0%), respectively. Seventy-four percent of patients with AACE and 63% of patients with infantile esotropia achieved a motor success. Eighty-five percent of patients with AACE achieved a sensory success. The postoperative drift at distance and at near was not significant in both groups [AACE 0 PD (-6 to 10), <i>p</i> = .26 and 2 PD (-2 to 6), <i>p</i> = .44; infantile esotropia [8 PD (0-14), <i>p</i> = .12 and 4 PD (0-10), <i>p</i> = .22]. <i>Conclusions</i>: The BMRR in infantile esotropia had a larger surgical dose-response than in AACE. In both groups, the surgical dose-responses at near were greater than at distance. There was no significant postoperative drift at distance and at near in both groups.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A study of the relative orientation of the extraocular rectus muscles: an advanced cadaveric approach. 眼外直肌相对方向的研究:一种先进的尸体方法。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-08-19 DOI: 10.1080/09273972.2024.2388076
Andrew T Barton, Viren K Rana, Eric J Kim, Surya Khatri, James Y Lee, Jamie Schaefer

Purpose: The anatomy of the extraocular rectus muscle insertions is clinically relevant in the field of ophthalmology. This descriptive cadaveric study determines the relative degree orientation of the superior, lateral, and inferior rectus muscles with respect to the medial rectus and investigates the distances between the rectus muscle insertions. Method: Thirty cadavers (50% female, mean age = 81.86 years, SD 12.16) were included for a total of 60 eyes. For each eye, a lateral canthotomy and cantholysis were performed followed by a peritomy. Muscle hooks were then used to access and isolate the rectus muscles. The degree orientation was determined by marking the muscle midpoints at insertion, using the center of the cornea as the vertex, and measuring the angle with the Angle Meter 360 application (© Alexey Kozlov) (Figure 1). The distances between rectus muscles were measured from the same muscle midpoints using calipers. Results: The degree orientations with respect to the medial rectus are displayed in Figure 2 and were as follows: superior rectus (mean = 93.14, SD = 3.04, min. 82.3, max. 100.3), lateral rectus (mean = 180.21, SD = 5.65, min. 170.5, max. 190.6), and inferior rectus (mean = 90.57, SD = 4.47, min. 84.0, max. 98.9). The distances (measured in mm) between rectus muscle midpoints at insertion included medial rectus to inferior rectus (mean = 13.64, SD = 0.54), inferior rectus to lateral rectus (mean = 13.79, SD = 0.75), lateral rectus to superior rectus (mean = 13.54, SD = 0.63), and superior rectus to medial rectus (mean = 13.83, SD = 0.75). The relative distances between the midpoints of the extraocular muscles observed in males versus females showed statistically significant differences in medial rectus to inferior rectus (13.8 vs. 13.5, p = .01), inferior rectus to lateral rectus (14.1 vs. 13.5, p = .03), and superior rectus to medial rectus (14.0 vs. 13.5, p = .04), respectively (Table 1). Conclusion: This is an important study of the extraocular muscle degree orientation performed with an innovative measuring approach. The degree orientation of the insertions relative to the medial rectus may have surgical application in the field of ophthalmology.

目的:眼外直肌插入点的解剖与眼科临床相关。这项描述性尸体研究确定了上直肌肌、外侧直肌和下直肌相对于内侧直肌的相对位置,并调查了直肌插入点之间的距离。研究方法纳入 30 具尸体(50% 为女性,平均年龄 = 81.86 岁,标准差 12.16),共计 60 只眼睛。对每只眼睛进行外侧角切开术和角膜松解术,然后进行眼周切开术。然后使用肌肉钩进入并分离直肌。在插入处标记肌肉中点,以角膜中心为顶点,用角度计 360 应用程序(© Alexey Kozlov)测量角度,从而确定度数方向(图 1)。直肌之间的距离用卡尺从相同的肌肉中点测量。结果:图 2 显示了相对于内侧直肌的度数方向,具体如下:上直肌(平均值 = 93.14,标度 = 3.04,最小值 82.3,最大值 100.3)、外侧直肌(平均值 = 180.21,标度 = 5.65,最小值 170.5,最大值 190.6)和下直肌(平均值 = 90.57,标度 = 4.47,最小值 84.0,最大值 98.9)。直肌中点插入处之间的距离(以毫米为单位)包括内侧直肌到下直肌(平均值=13.64,SD=0.54),下直肌到外侧直肌(平均值=13.79,SD=0.75),外侧直肌到上直肌(平均值=13.54,SD=0.63),以及上直肌到内侧直肌(平均值=13.83,SD=0.75)。观察到的男性与女性眼外肌中点之间的相对距离在统计学上有显著差异,分别为内侧直肌到下侧直肌(13.8 vs. 13.5,p = .01)、下侧直肌到外侧直肌(14.1 vs. 13.5,p = .03)和上侧直肌到内侧直肌(14.0 vs. 13.5,p = .04)(表 1)。结论:这是一项采用创新测量方法进行的眼外肌度数方位的重要研究。插入肌相对于内侧直肌的度数方向可能在眼科领域有手术应用。
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引用次数: 0
Assessment of stereopsis in unilateral amblyopia subjects using syntonic phototherapy. 使用同步光疗评估单侧弱视患者的立体视。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-08-19 DOI: 10.1080/09273972.2024.2389228
Shakila Abbas, Malaika Younus, Ayesha Bukhari, Mahnoor Anwar, Aalia Iqrar

Introduction: Amblyopia is two Snellen line difference between both eyes. Red filter therapy is a treatment option for amblyopia based on principle of syntonic phototherapy. The purpose of this study is to assess the stereopsis in amblyopic patient using syntonic phototherapy.

Methods: A Qusai experimental study was conducted from August 2021 to December 2021 at Madina Teaching Hospital Faisalabad. A total 30 subjects of both gender and ages ranging between 8 to 18 years were included through a non-probability purposive sampling technique. The sample was considered of 15 anisometropic amblyopes and 15 strabismic amblyope. Data was collected using a Performa and pre assessments of stereopsis by Titmus fly chart were recorded without red filter. Red filter glasses were prescribed for 4 week, post assessment data was recorded after 4 weeks. Data was analyzed by using Paired sample T test and Independent Sample T test in SPSS 20 software.

Results: After syntonic phototherapy significant improvement was seen, mean stereopsis was 48.00000 (p = 0.002) in anisometropic amblyopes while mean improvement of stereopsis 1.670.93333 (p = 0.00) in strabismic amblyopes. Anisometropic amblyopic patients showed significantly better improvement in stereopsis (p = 0.00) by syntonic phototherapy as compared to strabismic amblyopes.

Conclusion: Significant improvement was seen in stereopsis, while improvement was more significant in anisometropic amblyopes as compared to strabismic amblyopes. Children were obsessed with the red filter glasses while their parents found syntonic therapy simple plus facile and gave good results. So, eye care professionals must be aware of this new therapy and they should keep syntonic phototherapy in mind whenever they are dealing with amblyopic patients.

简介弱视是指双眼视力相差两条斯奈伦线。红色滤光片疗法是一种基于同步光疗原理的弱视治疗方法。本研究的目的是评估弱视患者使用同步光疗的立体视情况:方法:2021 年 8 月至 2021 年 12 月在费萨拉巴德麦地那教学医院进行了一项 Qusai 实验研究。通过非概率目的性抽样技术,共纳入了 30 名年龄在 8 至 18 岁之间的男女受试者。样本中包括 15 名各向异性弱视患者和 15 名斜视弱视患者。收集数据时使用了表格,并在不使用红色滤光镜的情况下,通过 Titmus 飞碟图记录了立体视的预评估结果。配戴红色滤光眼镜 4 周后,记录 4 周后的评估数据。数据采用 SPSS 20 软件中的配对样本 T 检验和独立样本 T 检验进行分析:结果:接受同步光疗后,患者的立体视明显改善,各向异性弱视患者的平均立体视提高了 48.00000 (p = 0.002),而斜视弱视患者的平均立体视提高了 1.670.93333 (p = 0.00)。与斜视性弱视患者相比,各向异性弱视患者接受同步光疗后的立体视改善明显(p = 0.00):结论:与斜视性弱视患者相比,各向异性弱视患者的立体视有明显改善。孩子们对红色滤光眼镜情有独钟,而家长们则认为同步疗法简单易行,效果良好。因此,眼科专业人员必须了解这种新疗法,在治疗弱视患者时应牢记同步光疗法。
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引用次数: 0
Prevalence of strabismus in Pakistan: a systematic review and meta-analysis. 巴基斯坦斜视患病率:系统回顾与荟萃分析。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-10-01 DOI: 10.1080/09273972.2024.2408416
Zainab Zehra, Christopher S von Bartheld, Wishal Khan, Maleeha Azam, Raheel Qamar

Purpose: Strabismus is an ocular condition characterized by misalignment of the visual axis. The global prevalence of strabismus is about 2-3%, which varies between different countries and ethnicities. The aim of this study was to conduct a meta-analysis of studies, which had previously reported the prevalence of strabismus in Pakistan, in order to obtain the overall prevalence of strabismus in the country. Methods: All community-based studies reporting the prevalence of strabismus from Pakistan were searched using international databases and local ophthalmology journals. Information about sample size, number of individuals with strabismus, and location and duration of the study was recorded. Statistical analysis including heterogeneity testing, pooled prevalence calculation and regression analysis were done using the R software. Results: Heterogeneity tests, Pheterogeneity < .01, suggested high heterogeneity between the different studies. The pooled prevalence of strabismus was 0.7% [95% confidence interval (CI): 0.39%-1.23%] according to the random effects model, with a decreasing trend in prevalence from 1995 to 2020. Esotropia was more frequent than exotropia in both population-based and clinic-based studies. Conclusion: The prevalence of strabismus in Pakistan is comparatively lower than the worldwide prevalence, and it appears to be decreasing over the last three decades, consistent with global trends.

目的:斜视是一种以视轴错位为特征的眼部疾病。斜视的全球发病率约为 2-3%,不同国家和种族的发病率有所不同。本研究旨在对之前报道过巴基斯坦斜视患病率的研究进行荟萃分析,以了解该国斜视的总体患病率。研究方法利用国际数据库和当地眼科期刊搜索了所有报道巴基斯坦斜视患病率的社区研究。记录了样本大小、斜视患者人数、研究地点和持续时间等信息。使用 R 软件进行了统计分析,包括异质性检验、汇总患病率计算和回归分析。结果异质性检验、异质性结论:巴基斯坦的斜视患病率相对低于全球患病率,而且在过去三十年中似乎呈下降趋势,这与全球趋势一致。
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引用次数: 0
Anteriorization of the inferior oblique muscle versus anteriorization and resection for asymmetrical dissociated vertical deviation. 下斜肌前移术与下斜肌前移术和切除术治疗不对称分离性垂直偏位。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-09-19 DOI: 10.1080/09273972.2024.2402925
Ghada Osama, Hala Elhilali, Magda Salah, Heba M Fouad

Purpose: To compare the efficacy of two methods: first, bilateral symmetric anteriorization of the inferior oblique muscle and second: combined resection and anteriorization of the inferior oblique (IO) muscle for asymmetric dissociated vertical deviation (DVD).

Design: Prospective randomized clinical trial.

Methods: This study included fifty-four patients presenting with bilateral asymmetric DVD and inferior oblique overaction (IOOA). Two equal groups were randomly allocated by odd and even number distribution. Twenty-seven patients underwent bilateral symmetric anteriorization of the IO muscle and twenty-seven patients underwent anteriorization of the IO of one eye and anteriorization with IO resection in the eye with the larger deviation. According to the difference in measured DVD between the two eyes whether less or more than 5 PD; a 3 or 5 mm resection was done, respectively.

Results: The mean post-operative reduction of DVD in the anteriorization group was 9.19 ± 3.40 PD in the right eye and 8.78 ± 4.17 PD in the left eye, which were highly significant. (p-value .0002). The resection group had a mean post-operative DVD reduction of 11.7 ± 2.74 PD in resected eyes and 7.3 ± 3.72 PD in non-resected eyes. These reductions were also highly significant (p-value 0.0001). Reduction of inter-ocular difference between both groups failed to show a statistical difference (p-value 0.285). The IOOA was significantly reduced in both groups. Improvement in the average post-operative DVD between the two groups and the post-operative improvement in IOOA failed to show a statistically significant difference (p-value 0.265 and 0.804 respectively) which showed that both procedures are effective.

Conclusion: Both surgical modalities are effective in managing asymmetric dissociated vertical deviation associated with IOOA.

目的:比较两种方法的疗效:第一种是下斜肌双侧对称前移术,第二种是下斜肌(IO)联合切除和前移术治疗不对称分离性垂直偏斜(DVD):设计:前瞻性随机临床试验:这项研究包括54名患有双侧不对称DVD和下斜肌过度运动(IOOA)的患者。按照奇数和偶数分布随机分配两组。27 名患者接受了双侧对称的 IO 肌肉前移术,27 名患者接受了一只眼的 IO 前移术,并在偏差较大的那只眼进行了前移术和 IO 切除术。根据两眼测量的 DVD 差异(小于或大于 5 PD),分别进行了 3 毫米或 5 毫米的切除:结果:前角化组术后右眼的平均 DVD 减少量为 9.19 ± 3.40 PD,左眼为 8.78 ± 4.17 PD,差异非常显著。(P值为0.0002)。切除组的术后 DVD 平均减少量为 11.7 ± 2.74 PD(切除眼)和 7.3 ± 3.72 PD(未切除眼)。这些减少也非常显著(P 值为 0.0001)。两组患者的眼球间差的减少均未显示出统计学差异(P 值为 0.285)。两组患者的 IOOA 均明显减少。两组术后平均 DVD 值的改善和术后 IOOA 值的改善在统计学上无明显差异(P 值分别为 0.265 和 0.804),这表明两种手术方法均有效:结论:两种手术方式都能有效治疗与 IOOA 相关的不对称分离性垂直偏斜。
{"title":"Anteriorization of the inferior oblique muscle versus anteriorization and resection for asymmetrical dissociated vertical deviation.","authors":"Ghada Osama, Hala Elhilali, Magda Salah, Heba M Fouad","doi":"10.1080/09273972.2024.2402925","DOIUrl":"10.1080/09273972.2024.2402925","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy of two methods: first, bilateral symmetric anteriorization of the inferior oblique muscle and second: combined resection and anteriorization of the inferior oblique (IO) muscle for asymmetric dissociated vertical deviation (DVD).</p><p><strong>Design: </strong>Prospective randomized clinical trial.</p><p><strong>Methods: </strong>This study included fifty-four patients presenting with bilateral asymmetric DVD and inferior oblique overaction (IOOA). Two equal groups were randomly allocated by odd and even number distribution. Twenty-seven patients underwent bilateral symmetric anteriorization of the IO muscle and twenty-seven patients underwent anteriorization of the IO of one eye and anteriorization with IO resection in the eye with the larger deviation. According to the difference in measured DVD between the two eyes whether less or more than 5 PD; a 3 or 5 mm resection was done, respectively.</p><p><strong>Results: </strong>The mean post-operative reduction of DVD in the anteriorization group was 9.19 ± 3.40 PD in the right eye and 8.78 ± 4.17 PD in the left eye, which were highly significant. (<i>p</i>-value .0002). The resection group had a mean post-operative DVD reduction of 11.7 ± 2.74 PD in resected eyes and 7.3 ± 3.72 PD in non-resected eyes. These reductions were also highly significant (<i>p</i>-value 0.0001). Reduction of inter-ocular difference between both groups failed to show a statistical difference (<i>p</i>-value 0.285). The IOOA was significantly reduced in both groups. Improvement in the average post-operative DVD between the two groups and the post-operative improvement in IOOA failed to show a statistically significant difference (<i>p</i>-value 0.265 and 0.804 respectively) which showed that both procedures are effective.</p><p><strong>Conclusion: </strong>Both surgical modalities are effective in managing asymmetric dissociated vertical deviation associated with IOOA.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"28-35"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Angiographically silent macular retinoschisis and vitreomacular traction in a patient with same - side Duane retraction syndrome. 一名同侧杜安回缩综合征患者的血管造影无黄斑视网膜裂孔和玻璃体黄斑牵引。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-09-03 DOI: 10.1080/09273972.2024.2399351
Işıl Kefeli, Aylin Yaman, Ali Osman Saatci

Introduction: To report the unusual fundus features of a case with unilateral Duane retraction syndrome (DRS) with same-side extensive macular retinoschisis. Methods: A 75-year-old woman was diagnosed to have DRS type 3 and several multimodal fundus imaging modalities were performed. Results: There was limited abduction and adduction, globe retraction, and narrowing of the palpebral fissure on the adduction of the left eye without a compensatory face turn. Concurrently, spectral domain optical coherence tomography revealed marked macular retinoschisis and severe vitreoretinal traction without any evidence of dye leakage or pooling on fluorescein angiography in the left eye. Discussion: Various ocular abnormalities may rarely accompany DRS and the present case is the first reported case of most likely coincidental macular retinoschisis in association with DRS.

导言:报告一例单侧杜安回缩综合征(DRS)伴同侧广泛黄斑视网膜裂孔的异常眼底特征。方法:对一名 75 岁的女性患者诊断为 DRS 3 型,并进行了多种多模态眼底成像检查。结果:左眼外展和内收受限,眼球后缩,内收时睑裂变窄,无代偿性转脸。同时,光谱域光学相干断层扫描显示左眼有明显的黄斑视网膜裂孔和严重的玻璃体视网膜牵引,但荧光素血管造影没有任何染料渗漏或汇集的迹象。讨论:各种眼部异常很少会伴随 DRS,本病例是第一例报告的很可能与 DRS 同时发生的黄斑视网膜裂孔。
{"title":"Angiographically silent macular retinoschisis and vitreomacular traction in a patient with same - side Duane retraction syndrome.","authors":"Işıl Kefeli, Aylin Yaman, Ali Osman Saatci","doi":"10.1080/09273972.2024.2399351","DOIUrl":"10.1080/09273972.2024.2399351","url":null,"abstract":"<p><p><i>Introduction:</i> To report the unusual fundus features of a case with unilateral Duane retraction syndrome (DRS) with same-side extensive macular retinoschisis. <i>Methods:</i> A 75-year-old woman was diagnosed to have DRS type 3 and several multimodal fundus imaging modalities were performed. <i>Results:</i> There was limited abduction and adduction, globe retraction, and narrowing of the palpebral fissure on the adduction of the left eye without a compensatory face turn. Concurrently, spectral domain optical coherence tomography revealed marked macular retinoschisis and severe vitreoretinal traction without any evidence of dye leakage or pooling on fluorescein angiography in the left eye. <i>Discussion:</i> Various ocular abnormalities may rarely accompany DRS and the present case is the first reported case of most likely coincidental macular retinoschisis in association with DRS.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"58-60"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stability of the angle of deviation in basic intermittent exotropia (IXT) following surgical correction: a retrospective observational study from southern India. 基本间歇性外斜(IXT)手术矫正后偏角的稳定性:印度南部的一项回顾性观察研究。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-08-20 DOI: 10.1080/09273972.2024.2391413
Sandra Chandramouli, Rebecca Claire Lusobya, Jaga Janani A, John Mukisa, Kalpana Narendran

Introduction: Intermittent exotropia (IXT) is commonly seen in areas with more sunlight, females and Asians. Surgical alignment is recommended to improve binocular function, but a high recurrence rate has been reported. This study aimed to assess the stability of ocular alignment and factors contributing to exodrift post-surgery for IXT over 6-month follow-up. Methods: We retrospectively reviewed the medical records of patients with IXT who underwent unilateral recess resect procedures and attended follow-up examinations for at least six months post-surgery. A significant exodrift was defined as exodrift of more than 10PD at distance and near. Ocular deviation, binocularity, and stereopsis at one and six-month post-operative visits were studied to assess the incidence of exodrift post-surgery and the probable factors causing such drift. Results: Of the 50 patients studied, 26 (52%) were males, 42 (84%) were <20 years. The median age at surgery was 10 years (range 6-14), and the median preoperative angle of deviation was 37 PD. Majority of patients (62%) had exodrift within six months of surgery, and about a quarter of the study population had significant exodrift >10 PD. No clinical factors were found to contribute significantly to exodrift in this study.16 (61.5%) patients attained near and distance BSV post-surgery (p-value: <0.001). Six (12%) and 10 (20%) patients with subnormal near and distance stereopsis, respectively, attained normal stereopsis post-surgery. Conclusion: Over half of the patients operated for IXT had some Exodrift, and one-fourth had significant exodrift within six months post-surgery. Despite improved BSV, many patients failed to attain normal stereopsis with just motor alignment.

简介间歇性外斜(IXT)常见于日照较多的地区、女性和亚洲人。建议通过手术矫正来改善双眼功能,但有报道称复发率很高。本研究旨在评估 IXT 手术后 6 个月随访期间眼球对位的稳定性以及导致外斜的因素。方法:我们回顾性地查阅了接受单侧眼球后凹切除术的 IXT 患者的病历,并对其进行了术后至少 6 个月的随访检查。明显的眼球外斜是指远近眼球外斜超过 10PD 。研究人员对术后一个月和六个月的眼球偏斜、双眼视力和立体视进行了研究,以评估术后眼球外斜的发生率以及导致眼球外斜的可能因素。研究结果在接受研究的 50 名患者中,26 名(52%)为男性,42 名(84%)为 10 例白内障患者。16(61.5%)名患者在术后达到了近距离和远距离 BSV(P 值为 0.05):结论超过一半的 IXT 患者在手术后六个月内有一些外翻,四分之一的患者有明显的外翻。尽管 BSV 有所改善,但许多患者仅靠运动对齐仍无法达到正常的立体视。
{"title":"Stability of the angle of deviation in basic intermittent exotropia (IXT) following surgical correction: a retrospective observational study from southern India.","authors":"Sandra Chandramouli, Rebecca Claire Lusobya, Jaga Janani A, John Mukisa, Kalpana Narendran","doi":"10.1080/09273972.2024.2391413","DOIUrl":"10.1080/09273972.2024.2391413","url":null,"abstract":"<p><p><i>Introduction</i>: Intermittent exotropia (IXT) is commonly seen in areas with more sunlight, females and Asians. Surgical alignment is recommended to improve binocular function, but a high recurrence rate has been reported. This study aimed to assess the stability of ocular alignment and factors contributing to exodrift post-surgery for IXT over 6-month follow-up. <i>Methods</i>: We retrospectively reviewed the medical records of patients with IXT who underwent unilateral recess resect procedures and attended follow-up examinations for at least six months post-surgery. A significant exodrift was defined as exodrift of more than 10PD at distance and near. Ocular deviation, binocularity, and stereopsis at one and six-month post-operative visits were studied to assess the incidence of exodrift post-surgery and the probable factors causing such drift. <i>Results</i>: Of the 50 patients studied, 26 (52%) were males, 42 (84%) were <20 years. The median age at surgery was 10 years (range 6-14), and the median preoperative angle of deviation was 37 PD. Majority of patients (62%) had exodrift within six months of surgery, and about a quarter of the study population had significant exodrift >10 PD. No clinical factors were found to contribute significantly to exodrift in this study.16 (61.5%) patients attained near and distance BSV post-surgery (<i>p</i>-value: <0.001). Six (12%) and 10 (20%) patients with subnormal near and distance stereopsis, respectively, attained normal stereopsis post-surgery. <i>Conclusion</i>: Over half of the patients operated for IXT had some Exodrift, and one-fourth had significant exodrift within six months post-surgery. Despite improved BSV, many patients failed to attain normal stereopsis with just motor alignment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"6-12"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
One- vs Two- vertical muscle surgery in the management of unilateral superior oblique muscle palsy with hypertropia over 20 PD. 单侧上斜肌麻痹并伴有超过 20 PD 的肥大症的单侧垂直肌手术与双侧垂直肌手术。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-09-19 DOI: 10.1080/09273972.2024.2401439
Hajar Farvardin, Fatemeh Ebrahimi, Hadi Farvardin, Majid Farvardin

Purpose: To compare the surgical outcomes of One- versus Two-vertical muscle surgery in patients with unilateral superior oblique muscle palsy (SOP) with primary position hypertropia (HT) over 20 PD. Patients in Group 1 underwent inferior oblique anterior transposition plus resection (IOATR), while patients in Group 2 underwent inferior oblique anterior transposition (IOAT) along with contralateral inferior rectus (IR) recession. Methods: Medical data of all SOP patients treated by either procedure from 2000 to 2023 in our strabismus center were recruited. We compared surgical outcomes between Group 1 and Group 2 by analyzing HT correction, rate of under-correction, and over-correction. Results: The study included 33 patients in Group 1 and 23 in Group 2. Both groups were similar in age, sex, etiology, affected side, diplopia, and head tilt. Group 2 achieved higher HT correction in all measured gazes. Group 1 had a higher risk of under-correction (18.18% in Group 1 vs 8.69% in Group 2) while Group 2 had a higher rate of over-correction (21.73% vs 0% in Group 1). Conclusion: In patients with severe unilateral SOP, Two-vertical muscle surgery achieved higher amounts of HT correction in all gazes despite a significantly higher risk of over-correction.

目的:比较单侧上斜肌麻痹(SOP)且原发性体位性肥大(HT)超过 20 PD 的患者接受单垂直肌手术与双垂直肌手术的手术效果。第一组患者接受下斜肌前转位加切除术(IOATR),第二组患者接受下斜肌前转位术(IOAT)和对侧下直肌(IR)切除术。方法收集本斜视中心 2000 年至 2023 年期间所有接受过两种手术治疗的 SOP 患者的医疗数据。通过分析 HT 矫正、矫正不足率和矫正过度率,比较第一组和第二组的手术效果。研究结果两组患者在年龄、性别、病因、患侧、复视和头部倾斜方面相似。第 2 组在所有测量的注视中都获得了更高的 HT 矫正。第一组出现矫正不足的风险较高(第一组为 18.18%,第二组为 8.69%),而第二组出现矫正过度的风险较高(第一组为 21.73%,第二组为 0%)。结论对于严重的单侧 SOP 患者,尽管过度矫正的风险明显较高,但两垂直肌手术在所有注视点都能获得较高的 HT 矫正效果。
{"title":"One- vs Two- vertical muscle surgery in the management of unilateral superior oblique muscle palsy with hypertropia over 20 PD.","authors":"Hajar Farvardin, Fatemeh Ebrahimi, Hadi Farvardin, Majid Farvardin","doi":"10.1080/09273972.2024.2401439","DOIUrl":"10.1080/09273972.2024.2401439","url":null,"abstract":"<p><p><i>Purpose:</i> To compare the surgical outcomes of One- versus Two-vertical muscle surgery in patients with unilateral superior oblique muscle palsy (SOP) with primary position hypertropia (HT) over 20 PD. Patients in Group 1 underwent inferior oblique anterior transposition plus resection (IOATR), while patients in Group 2 underwent inferior oblique anterior transposition (IOAT) along with contralateral inferior rectus (IR) recession. <i>Methods:</i> Medical data of all SOP patients treated by either procedure from 2000 to 2023 in our strabismus center were recruited. We compared surgical outcomes between Group 1 and Group 2 by analyzing HT correction, rate of under-correction, and over-correction. <i>Results:</i> The study included 33 patients in Group 1 and 23 in Group 2. Both groups were similar in age, sex, etiology, affected side, diplopia, and head tilt. Group 2 achieved higher HT correction in all measured gazes. Group 1 had a higher risk of under-correction (18.18% in Group 1 vs 8.69% in Group 2) while Group 2 had a higher rate of over-correction (21.73% vs 0% in Group 1). <i>Conclusion:</i> In patients with severe unilateral SOP, Two-vertical muscle surgery achieved higher amounts of HT correction in all gazes despite a significantly higher risk of over-correction.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"13-19"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corneal changes after large (9mm) lateral rectus muscle recession measured with Pentacam®. 使用 Pentacam® 测量大面积(9 毫米)侧直肌后角膜的变化。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-09-19 DOI: 10.1080/09273972.2024.2402455
Konstantinos Paraskevopoulos, Christina Karakosta, Georgios Feretzakis, Maria Liaskou, Vassilios S Verykios, Konstantinos Droutsas, Dimitrios Papakonstantinou, Ilias Georgalas

Introduction: The aim of this study was to evaluate alterations in corneal astigmatism, axial anterior corneal curvature, anterior chamber depth, and central corneal thickness (CCT) two months after the unilateral recession of lateral rectus muscle in children. Methods: This prospective study included 37 children with intermittent exotropia who would undergo unilateral lateral rectus muscle recession. All measurements were performed using Pentacam®. Comparisons were made between the operated and fellow unoperated eyes, pre- and post-operatively. The assessment was made for changes in the radius of axial curvature on major meridians at 3 and 3.5 mm from the optical corneal center in the mid-peripheral zone. Astigmatism changes of the anterior and posterior corneal surface were calculated using vector analysis software (astigMATIC®). The interaction between age or CCT and postoperative changes in anterior and posterior surface corneal astigmatism were examined with ANOVA model. Results: In the intervention group, changes in anterior and posterior corneal surface astigmatism were statistically significant, with a mean increase of 0.56Dx90 and 0.08Dx87, respectively. In the mid-peripheral corneal zone, an increase was observed in the radius of anterior corneal axial curvature, more evident temporal 3 and 3.5 mm from the corneal center on the horizontal meridian, with corresponding decrease superiorly and inferiorly at 3 and 3.5 mm from the corneal center on the vertical meridian. Discussion: The changes in total astigmatism of the operated eyes are mainly attributed to the anterior corneal surface. These changes are associated with flattening in the 180 meridian of the cornea, leading to a shift to "with-the-rule" astigmatism.

简介本研究旨在评估单侧侧直肌后退两个月后儿童角膜散光、轴向角膜前曲率、前房深度和角膜中央厚度(CCT)的变化。研究方法这项前瞻性研究包括 37 名患有间歇性外斜的儿童,他们将接受单侧侧直肌后退术。所有测量均使用 Pentacam® 进行。术前和术后,对接受手术的眼睛和未接受手术的眼睛进行比较。评估对象为中周边区距光学角膜中心 3 毫米和 3.5 毫米处主要经线的轴曲率半径变化。使用矢量分析软件(astigMATIC®)计算角膜前后表面的散光变化。用方差分析模型检验了年龄或 CCT 与术后角膜前后表面散光变化之间的交互作用。结果显示在干预组中,角膜前后表面散光的变化具有统计学意义,平均分别增加了 0.56Dx90 和 0.08Dx87。在角膜中周区域,观察到角膜前轴曲率半径增加,在水平经线上距离角膜中心 3 毫米和 3.5 毫米的颞侧更为明显,在垂直经线上距离角膜中心 3 毫米和 3.5 毫米的上侧和下侧相应减少。讨论术眼总散光的变化主要归因于角膜前表面。这些变化与角膜 180 度经线的变平有关,导致向 "随规则 "散光的转变。
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引用次数: 0
Online resources for strabismus: an evaluation of readability, complexity, and suitability. 斜视在线资源:可读性、复杂性和适用性评估。
IF 0.8 Q4 OPHTHALMOLOGY Pub Date : 2025-03-01 Epub Date: 2024-10-01 DOI: 10.1080/09273972.2024.2408029
Kristin Davis, Caitlin Blades, Scott Larson

Introduction: Over one-third of US adults have never attended college, creating a large disparity in the readability of online health materials. Decreased health literacy and accessibility to medical information negatively affect patients and well-informed patients are more likely to experience better health outcomes (1). The NIH and AMA recommend patient-intended education materials be written at a sixth-grade reading level (2), therefore, this study analyzed the accessibility of the top ten web pages for "strabismus."

Methods: The first ten online resources returned in a Google search for "strabismus" were analyzed. Web pages were then assessed for the readability level (Simple Measure of Gobbledygook), complexity (PMOSE/IKIRSCH), and suitability (Suitability Assessment of Materials). Two independent raters assessed the complexity and suitability.

Results: Readability analysis of the strabismus resources revealed an average reading grade level of 11.4 ± 1.07. There was a statistical difference in the reading grade level between the .com and .gov, and the .org and .com websites (p = .029 and p = .031, respectively). Complexity analysis revealed a mean score of 6.50 ± 2.29, corresponding to an 8th-12th grade reading level. The suitability assessment showed a mean value of 70.3 ± 10.1%, representing a "superior" score for the information provided to the reader. The inter-rater agreement was similar for the complexity and fair for the suitability analysis.

Discussion: On average, online resources for strabismus have a low complexity level. However, the majority of the top ten articles reviewed are above the recommended literacy level, indicating a need for revision.

Clinical implications: The vast amount of available online health resources have significantly affected the field of medicine. Most patients research their disease process using online sources and many reference this material before their initial ophthalmologic consultation. Considering that more than half of Americans read below the equivalent of a sixth-grade level and that the AMA/NIH recommend all patient-intended materials to be written above this level, there is a health literacy disconnect. This limits patients' ability to educate themselves about their medical conditions and participate in informed conversations regarding their healthcare. Patients who are unable to interpret health information accurately have increased rates of hospitalization, develop more medical conditions, and experience a higher rate of mortality. This preventable impediment to informed healthcare care magnifies the urgency for easily readable online resources that are formatted in a manner that is clear to understand and suitable for patients with lower health literacy.

简介超过三分之一的美国成年人从未上过大学,这就造成了在线健康资料可读性方面的巨大差距。健康素养的降低和医疗信息的可获取性会对患者产生负面影响,而知情的患者更有可能获得更好的健康结果(1)。美国国立卫生研究院(NIH)和美国医学会(AMA)建议,患者所需的教育材料应按照六年级的阅读水平编写(2),因此,本研究分析了 "斜视 "十大网页的可读性:对谷歌搜索 "斜视 "时返回的前十个在线资源进行分析。然后对网页的可读性水平(Simple Measure of Gobbledygook)、复杂性(PMOSE/IKIRSCH)和适用性(Suitability Assessment of Materials)进行评估。由两名独立评分员对复杂性和适用性进行评估:斜视资源的可读性分析表明,平均阅读水平为 11.4 ± 1.07。.com和.gov以及.org和.com网站的阅读水平存在统计学差异(分别为p = .029和p = .031)。复杂性分析显示,平均得分为 6.50 ± 2.29,相当于 8-12 年级的阅读水平。适宜性评估显示平均值为 70.3 ± 10.1%,代表向读者提供的信息得分 "优"。在复杂性分析中,评分者之间的一致性相似,而在适宜性分析中,评分者之间的一致性尚可:讨论:平均而言,斜视在线资源的复杂程度较低。临床意义:临床意义:大量可用的在线医疗资源对医学领域产生了重大影响。大多数患者都会通过网络资源研究自己的疾病过程,许多人在初次眼科就诊前就会参考这些资料。考虑到半数以上美国人的阅读能力低于相当于六年级的水平,而美国医学会/美国国立卫生研究院建议所有患者使用的资料都应高于这一水平,因此存在着健康知识脱节的问题。这限制了患者了解自身病情和参与有关医疗保健的知情对话的能力。无法准确解读健康信息的患者住院率会增加,病情会加重,死亡率也会升高。这种可预防的阻碍知情医疗保健的因素凸显了易读性在线资源的紧迫性,这些资源的格式清晰易懂,适合健康素养较低的患者使用。
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