Ординатура / Офтальмология / Английские материалы / Handbook of Pediatric Strabismus and Amblyopia_Wright, Spiegel, Thompson_2006
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57.Hwang JM, Wright KW. Combined study on the causes of strabismus after retinal surgery. Korean J Ophthalmol 1994;8(2):83–91.
58.Ingham PN, McGovern ST, Crompton JL. Congenital absence of the inferior rectus muscle. Aust NZ J Ophthalmol 1986;14(4):355–358.
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65.Lee J, et al. Results of a prospective randomized trial of botulinum toxin therapy in acute unilateral sixth nerve palsy. J Pediatr Ophthalmol Strabismus 1994;31:283–286.
66.Lengyel D, Zaunbauer W, Keller E, Gottlob I. Mobius syndrome: MRI findings in three cases. J Pediatr Ophthalmol Strabismus 2000;37(5): 305–308.
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73.Metz HS. Double elevator palsy. Arch Ophthalmol 1979;97:901– 909.
74.Metz HS, Dickey CF. Treatment of unilateral acute sixth nerve palsy with botulinum toxin. Am J Ophthalmol 1991;112:381–384.
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77.Mitchell PR, Wheeler MB, Parks MM, Kestenbaum surgical procedure for torticollis secondary to congenital nystagmus. J Pediatr Ophthalmol Strabismus 1987;24(2):87–93.
78.Munoz M, Rosenbaum AL. Long-term strabismus complications following retinal detachment surgery. J Pediatr Ophthalmol Strabismus 1987;24(6):309–314.
79.Nakano M, Yamada K, Fain J, et al. Homozygous mutations in ARIX (PHOX2A) result in congenital fibrosis of the extraocular muscles type 2. Nat Genet 2001.
80.Nardi M, Barca L. Hypercorrection of hypotropia in Graves’ ophthalmopathy. Ophthalmology 1993Jan;100(1):1–2.
81.Neely DE, Helveston EM, Thuente DD, Plager DA. Relationship of dissociated vertical deviation and the timing of initial surgery for congenital esotropia. Ophthalmology 2001;108(3):487–490.
82.Neugebauer A, Fricke J, Kirsch A, Russmann W. Modified transposition procedure of the vertical recti in sixth nerve palsy. Am J Ophthalmol 2001;131(3):359–363.
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83.Oh SY, Clark RA, Velez F, Demer JL. Magnetic resonance imaging demonstration of instability of rectus pulleys as cause of incomitant strabismus. Investig Ophthalmol Vis Sci 2001;167:42–44.
84.Parks MM. Causes of the adhesive syndrome In: Symposium on strabismus. Transaction of the New Orleans Academy of Ophthalmology. St Louis: Mosby, 1978:269–279.
85.Pearlman JT, Christensen RE. Motility problems following retinal detachment surgery. Am Orthopt J 1972;22:64–67.
86.Pedraza S, Gamez J, Rovira A, et al. MRI findings in Möbius syndrome: correlation with clinical features. Neurology 2000;55(7): 1058–1060.
87.Peleg D, Nelson GM, Williamson RA, Widness JA. Expanded Möbius syndrome. Pediatr Neurol 2001;24(4):306–309.
88.Pinchoff BS, Sandall G. Congenital absence of the superior oblique tendon in craniofacial dysostosis. Ophthalmic Surg 1985;16(6):375– 377.
89.Porter JD, Baker RS. Absence of oculomotor and trochlear motoneurons leads to altered extraocular muscle development in the Wnt-1 null mutant mouse. Dev Brain Res 1997;100(1):121– 126.
90.Prata JA, Minckler DS, Green RL. Pseudo-Brown’s syndrome as a complication of glaucoma drainage implant surgery. Ophthalmic Surg 1993;24:608–611.
91.Prendiville P, Chopra M, Gauderman WJ, Feldon SE. The role of restricted motility in determining outcomes for vertical strabismus surgery in Graves’ ophthalmology. Ophthalmology 2000;107(3):545– 549.
92.Price RL, Pederzolli A. Strabismus following retinal detachment surgery. Am Orthopt J 1982;32:9–17.
93.Quinn AG, Kraft SP, Day C, Taylor RS, Levin AV. A prospective evaluation of anterior transposition of the inferior oblique muscle, with and without resection, in the treatment of dissociated vertical deviation. J Am Assoc Pediatr Ophthalmol Strabismus 2000;4(6):348– 353.
94.Raab EL. Clinical features of Duane’s syndrome. J Pediatr Ophthalmol Strabismus 1986;23:64–68.
95.Raina J, Wright KW, Lin MM, McVey JH. Effectiveness of lateral rectus Y split surgery for correcting the upshoot and downshoot in Duane’s retraction syndrome, Type III. Binoc Vis Strabismus 1997; 12(4):233–238.
96.Reck AC, Manners R, Hatchwell E. Phenotypic heterogeneity may occur in congenital fibrosis of the extraocular muscles. Br J Ophthalmol 1998;82(6):676–679.
97.Reinecke RD. Retroequatorial placement of horizontal recti. J Pediatr Ophthalmol Strabismus 1996;33(3):201–202.
98.Rene C, Rose GE, Lenthall R, Moseley I. Major orbital complications of endoscopic sinus surgery. Br J Ophthalmol 2001;85(5):598–603 (review).
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99.Roberts EL, Saunders RA, Wilson ME. Surgery for vertical head position in null point nystagmus. J Pediatr Ophthalmol Strabismus 1996;33(4):219–224.
100.Rogers GL, Bremer DL. Surgical treatment of the upshoot and downshoot in Duane’s retraction syndrome. Ophthalmology 1984;91(11): 1380–1383.
101.Romano PE. Absent or hypoplastic extraocular muscles? J Med Genet 1989;26(3):216.
102.Rosenbaum A, Kushner BJ, Kirschen D. Vertical rectus muscle transposition and botulinum toxin (oculinum) to medial rectus for abducens palsy. Arch Ophthalmol 1989;107:820.
103.Roth AM, Sypnicki BA. Motility dysfunction following surgery for retinal detachment. Am Orthopt J 1975;25:118–121.
104.Saunders RA, Rogers CT. Superior oblique transposition for third nerve palsy. Ophthalmology 1982;89:310.
105.Schumacher-Feero LA, Yoo KW, Solari FM, Biglan AW. Third cranial nerve palsy in children. Am J Ophthalmol 1999;128(2):216– 221.
106.Scott WE, Jackson OB. Double elevator palsy: the significance of inferior rectus restriction. Ophthalmology 1977;27:5–10.
107.Scott AB, Wong GY. Duane’s syndrome: an electromyographic study. Arch Ophthalmol 1972;87:142–147.
108.Seiff SR, Good WV. Hypertropia and the posterior blowout fracture: mechanism and management. Ophthalmology 1996;103(1):152– 156.
109.Sener EC, Lee BA, Turgut B, Akarsu AN, Engle EC. A clinically variant fibrosis syndrome in a Turkish family maps to the CFEOM1 locus on chromosome 12. Arch Ophthalmol 2000;118(8):1090–1097.
110.Sewell JJ, Knobloch WH, Eifrig DE. Extraocular muscle imbalance after surgical treatment for retinal detachment. Am J Ophthalmol 1974;78:321.
111.Smiddy WE, Loupe D, Michels RG, et al. Extraocular muscle imbalance after scleral buckling surgery. Ophthalmology 1989;96:1485– 1490.
112.Smith SL, Starita RJ, Fellman RL, Lynn JR. Early clinical experience with the Baerveldt 350-mm2 glaucoma implant and associated extraocular muscle imbalance. Ophthalmology 1993;100:914–918.
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114.Stager DR, Weakley DR, Stager D. Anterior transposition of the inferior oblique: anatomic assessment of the neurovascular bundle. Arch Ophthalmol 1992;110:360–362.
115.Strachan IM, Brown BH. Electromyography of extraocular muscles in Duane’s syndrome. Br J Ophthalmol 1972;56:594–599.
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117.Theodossiadis G, Nikolakis S, Apostolopoulos M. Immediate postoperative muscular disturbance in retinal detachment surgery. Mod Probl Ophthalmol 1979;20:367–372.
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119.Trotter WL, Kaw P, Meyer DR, Simon JW. Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery. J Am Assoc Pediatr Ophthalmol Strabismus 2000;4(4):250– 253.
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121.Varn MM, Saunders RA, Wilson ME. Combined bilateral superior rectus muscle recession and inferior oblique muscle weakening for dissociated vertical deviation. J Am Assoc Pediatr Ophthalmol Strabismus 1997;1(3):134–137.
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126.Wilson WB, Prochoda M. Radiotherapy for thyroid orbitopathy. Effects on extraocular muscle balance. Arch Ophthalmol 1995; 113(11):1420–1425.
127.Wilson ME, Parks MM. Primary inferior oblique overaction in congenital esotropia: accommodative esotropia and intermittent exotropia. Ophthalmology 1989;96:952–957.
128.Wilson ME, Saunders RA, Berland JE. Dissociated horizontal deviation and accommodative esotropia: treatment options when an esoand an exodeviation co-exist. J Pediatr Ophthalmol Strabismus 1995; 32(4):228–230.
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133.Wright KW, Liu GY, Murphree AL, et al. Double elevator palsy, ptosis and jaw-winking. Am Orthopt J 1989;39:143–150.
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11
Strabismus Surgery
Kenneth W. Wright and Pauline Hong
This chapter discusses various strabismus surgery procedures and how they work. When a muscle contracts, it produces a force that rotates the globe. The rotational force that moves
an eye is directly proportional to the length of the moment arm (m) (Fig. 11-1A) and the force of the muscle contraction (F) (Fig. 11-1B).
Rotational force m F
where m moment arm and F muscle force.
Strabismus surgery corrects ocular misalignment by at least four different mechanisms: slackening a muscle (i.e., recession), tightening a muscle (i.e., resection or plication), reducing the length of the moment arm (i.e., Faden), or changing the vector of the muscle force by moving the muscle’s insertion site (i.e., transposition).
MUSCLE RECESSION
A muscle recession moves the muscle insertion closer to the muscle’s origin (Fig. 11-2), creating muscle slack. This muscle slack reduces muscle strength per Starling’s length–tension curve but does not significantly change the moment arm when the eye is in primary position (Fig. 11-3). The arc of contact of the rectus muscles wrapping around the globe to insert anterior to the equator of the eye allows for large recessions of the rectus muscles without significantly changing the moment arm. Figure 11-3 shows a 7.0-mm recession of the medial and lateral rectus muscles. Note there is no change in the moment arm with these large recessions. Thus, the effect of a recession on eye position is determined by the amount of muscle slack created.1a The
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FIGURE 11-1A,B. (A) Diagram of the horizontal rectus muscles shows the relationship of the moment arm (m) to the muscle axis and center of rotation. The moment arm intersects the center of rotation and is perpendicular to the muscle axis. The longer the moment arm, the greater the rotational force. (B) Starling’s length–tension curve. The relationship of a muscle’s force is proportional to the tension on the muscle. More tension on a muscle increases muscle force and slackening a muscle reduces its force. Note that the relationship is exponential, not linear: toward the end of the curve, a small amount of slackening produces a disproportionately large amount of muscle weakening.
A B C
FIGURE 11-2A–C. Drawing of rectus muscle recession (shaded muscle). The effect of the recession is greatest when the eye rotates toward the recessed muscle. (A) The eye rotates toward the recessed muscle, causing the recessed muscle to tighten, therefore reducing muscle slack. (B) A rectus muscle resection resulting in muscle slack. (C) The eye rotates toward the recessed muscle, and the muscle and the muscle slack increase.
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5.5
7.0
m
MR
FIGURE 11-3. Medial rectus muscle recession. Diagram shows normal insertion at 5.5 mm posterior to the limbus and a 7.0-mm medial rectus recession. In primary position, the moment arm (m) has not changed, so the effect of the recession is to create muscle slack rather than to change the moment arm.
amount of muscle slack is most accurately determined by measuring the recession from the muscle insertion.8
Note the exponential character of the length–tension curve, as there is a precipitous loss of muscle force at the end of the curve when muscle slack is increased (see Fig. 11-1B); this is why even small, inadvertent inaccuracies of large recessions ( 6– 7 mm) can cause dramatic changes in muscle force and result in an unfavorable outcome. Technical mistakes, such as allowing central muscle sag and not properly securing the muscle, can lead to large overcorrections. For example, each 0.5 mm of bilateral medial rectus recessions up to a recession of 5.5 mm
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will correct approximately 5 prism diopters (PD) of esotropia. However, for recessions greater than 5.5 mm, each additional 0.5 mm of recession results in 10 prism diopters of correction (see chart on inside cover). Thus, an overrecession of only 1.0 mm on a planned 6.0-mm bilateral medial rectus recession would result in a 20-prism diopter overcorrection. Figure 11-4 shows the proper rectus muscle recession, with the muscle well secured and no central muscle sag. The best way to prevent central muscle sag is to broadly splay the new insertion so it is approximately the same width as the original insertion.
A rectus muscle recession has its greatest effect in the field of action of the muscle. Figure 11-2 shows that muscle slack increases when the eye rotates toward the recessed muscle, thus reducing the rotational force on gaze toward the recessed muscle. In contrast, eye rotation away from the recessed muscle causes muscle slack to be reduced. In addition, on rotation away from the recessed muscle, the recessed muscle is inhibited (Sherrington’s law), minimizing the effect of the recession in this gaze. For example, a right medial rectus recession will produce an incomitant strabismus, with an exodeviation in primary position and a larger exodeviation in leftgaze with very little exodeviation in rightgaze. Induced incomitance can correct incomitant strabismus. If a patient has a small esotropia in primary position and a large esotropia in leftgaze, a right medial rectus recession would reduce the incomitance. Comitant strabismus, on the other hand, is best treated with bilateral symmetrical surgery.
Recessions are routinely performed on rectus muscles but can also be performed on oblique muscles. Inferior oblique muscle recession is a popular procedure for weakening the inferior oblique muscle. Recession of the superior oblique tendon has also been described. It not only slackens the superior oblique tendon but also changes the function of the muscle. A recession of the superior oblique tendon collapses the normally broad insertion and moves the new insertion nasal and anterior to the globe’s equator. This alteration changes the function of the superior oblique muscle and can result in unpredictable outcomes, including postoperative limitation of depression. A more controlled way of slackening the superior oblique tendon without changing the functional mechanics of the tendon insertion is a tendon-lengthening procedure, such as the Wright silicone tendon expander.