Strabismus最新文献

{"title":"How to reduce conjunctival cyst formation after strabismus surgery?","authors":"Zahid Hüseyinhan, Ceren Gürez, Yiğit Ülgen","doi":"10.1080/09273972.2023.2242428","DOIUrl":"10.1080/09273972.2023.2242428","url":null,"abstract":"<p><strong>Purpose: </strong>To determine our rate of conjunctival cyst developing after strabismus surgery and to minimize its formation.</p><p><strong>Materials and methods: </strong>The data of 4026 eyes of 2662 patients were included in our retrospective analysis of, those that underwent strabismus surgery at the Beyoğlu Eye Training and Research Hospital Strabismus Unit between 2015 and 2021. Clinical characteristics and follow-up data of patients were recorded together with age, sex, and operation type. All patients were examined postoperatively on 1st day, 1st month and 6th month.</p><p><strong>Results: </strong>The mean age of the patients was 15.66 ± 11.81 (1-59 years). While two eyes were operated on in 1494 patients, one eye was operated on in 1168 patients. The surgeries performed were recession and/or resection of the horizontal and vertical rectus muscles and inferior and superior oblique procedures. The conjunctival cyst was detected in 11 patients postoperatively between 20 days and 8 months. The cyst was detected on the nasal side in 7 cases and temporal in 4.</p><p><strong>Conclusion: </strong>Conjunctival cyst is a rare complication after strabismus surgery and it is thought to be caused by a proliferation of the conjunctival epithelium. In addition to proper closure of the conjunctiva, attention to personal hygiene, avoidance of contacts that may increase suture contamination, and attention to the fact that the operation period is not long are actions that can help prevent conjunctival cyst formation.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10003074","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}

{"title":"Inferior rectus muscle Y splitting procedure for near-distance hypotropia disparity: an alternative to the Faden procedure.","authors":"Amar Pujari","doi":"10.1080/09273972.2023.2252939","DOIUrl":"10.1080/09273972.2023.2252939","url":null,"abstract":"<p><p>A young male patient with unilateral pathological myopia complained of selective hypotropia for distance with exophoria. Due to large globe, a notable amount of inferior scleral show was evident. In this scenario, extensive dissection along inferior rectus muscle to perform a Faden procedure would have worsened the inferior scleral show. Thus, as an alternative, the anterior procedure, that is, \"inferior rectus muscle Y-splitting procedure with 4-mm recession\" was undertaken. At the end of 3 months follow up, the troublesome selective hypotropia for distance disappeared significantly with very little changes along the lower lid position. Therefore, in presence of specific anatomical limitations, the inferior rectus muscle Y splitting procedure can be considered in lieu of Faden procedure for near-distance hypotropia disparity.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233353","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}

{"title":"Postural stability in strabismus and amblyopia.","authors":"Ali Nouraeinejad","doi":"10.1080/09273972.2023.2236138","DOIUrl":"10.1080/09273972.2023.2236138","url":null,"abstract":"<p><strong>Background: </strong>Postural control is a complex skill based on the collaboration of dynamic sensory mechanisms, namely the visual, vestibular, and somatosensory systems.</p><p><strong>Methods: </strong>A literature survey regarding postural stability in strabismus and amblyopia was conducted using databases in order to collect data for a narrative review of published reports and available literature.</p><p><strong>Results: </strong>The results of the literature survey were analyzed to provide an overview of the current knowledge of postural stability in strabismus and amblyopia. The results revealed that although postural control depends on the fundamental integration of three essential components (the visual, vestibular, and somatosensory systems), the role of vision is critical in postural stability. Once normal binocular vision is undesirably disrupted in childhood by some reason, especially in strabismus and/or amblyopia, balance is also affected. Abnormal balance affects coordination in gross and fine motor controls in school-age children and results in weakened academic performance and delayed social progress. It also impacts a child's general health, self-esteem, and safety.</p><p><strong>Conclusions: </strong>Binocular vision is imperative for the maturation and preservation of balance control in children, as balance performance is reduced in strabismus and/or amblyopia.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866223","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}

{"title":"Efficacy of tetracaine eye drops in strabismus surgery: a systematic review and meta-analysis of randomized controlled trials.","authors":"Naser Almekhyal, Salman AlOtaibi, Zayed Alenezi, Salman Almutairi, Fahad Alharbi, Mohammad AlRtam","doi":"10.1080/09273972.2023.2253851","DOIUrl":"10.1080/09273972.2023.2253851","url":null,"abstract":"<p><strong>Aim: </strong>To comprehensively evaluate the efficacy and safety profile of tetracaine eye drops as a local anesthetic agent among pediatric patients undergoing for strabismus surgery.</p><p><strong>Methods: </strong>We systemically searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception until April 2023. We included randomized controlled trials (RCTs) comparing tetracaine and placebo or no intervention for intraoperative and postoperative outcomes in strabismus surgery patients. We used the Cochrane risk of bias-2 tool for the risk of bias assessment. Continuous variables were pooled as mean difference (MD) or standardized mean difference (SMD), and categorical variables were pooled as risk ratio (RR) with a 95% confidence interval (CI).</p><p><strong>Results: </strong>Six RCTs were included in the meta-analysis, with a total of 326 patients. There was no significant difference between the tetracaine and the control groups regarding the mean operative time (MD = -0.10 minutes, 95% CI [-3.79, 3.59], <i>p</i> = .96), the mean time to first analgesia (MD = -0.87 minutes, 95% CI [-11.15, 9.40], <i>P</i> = .87), the mean behavior score (SMD = -S0.48, 95% CI [-1.24, 0.28], <i>p</i> = .22), the rate of postoperative vomiting (RR = 1.27, 95% CI [0.62, 2.61], <i>p</i> = .52), or the number of additional analgesia (RR = 0.55, 95% CI [0.27, 1.13], <i>p</i> = .10).</p><p><strong>Conclusion: </strong>Our systematic review and meta-analysis found no significant differences in the safety and efficacy of tetracaine eye drops for strabismus surgery when compared to placebo or no intervention. Further investigation is needed to establish the best local anesthetic for strabismus surgery.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212088","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}

{"title":"Test retest variability in stereoacuity measurements.","authors":"Jignasa Mehta, Anna O'Connor","doi":"10.1080/09273972.2023.2252853","DOIUrl":"10.1080/09273972.2023.2252853","url":null,"abstract":"<p><p><i>Background</i>: A clinician's choice of stereotest is influenced by the robustness of the measurement, in terms of sensitivity, specificity and test-retest variability. In relation to the latter aspect, there are limited data on the test-retest variability of these new tests and how they compare to the more commonly used stereotests. Therefore, the aim of the study was to determine the test-retest variability of four different measures of stereoacuity (TNO, Frisby, Lang Stereopad and Asteroid (Accurate STEReotest On a mobIle Device)) and to compare the stereoacuity measurements between the tests in an adult population. <i>Methods</i>: Stereoacuity was measured twice using TNO, Frisby, Lang Stereopad and Asteroid. Inclusion criteria included adult participants (18 years and older), no known ophthalmic condition and VA (Visual Acuity) equal to or better than 0.3 logMAR (Logarithm of the Minimum Angle of Resolution) with interocular difference of less than 0.2 logMAR. Bland-Altman analysis was used to assess agreement within and between stereotests. Differences in stereo thresholds were compared using signed Wilcoxon tests. <i>Results</i>: Fifty-four adults (male: 23 and female: 31) with VA equal to or better than 0.3 logMAR in either eye and interocular difference less than 0.2 logMAR were assessed (mean age: 38 years, SD: 12.7, range: 18-72). The test-retest variability of all the clinical stereotests, with the exception of the Lang Stereopad (<i>p</i> = .03, Wilcoxon signed-rank test), was clinically insignificant as the mean bias was equal or less than 0.06 log seconds of arc (equivalent to 1.15 seconds of arc). While the Asteroid test had the smallest variation between repeated measures (mean bias: -0.01 log seconds of arc), the Frisby and Lang Stereopad tests had the narrowest and widest limits of agreement respectively. When comparing results between tests, the biggest mean bias was between Frisby and Lang Stereopad (-0.62 log seconds of arc), and 64.8% and 31.5% of differences were in the medium (21-100\" of arc) and larger (>100\" of arc) ranges respectively. <i>Conclusion</i>: The TNO and Frisby tests have good reliability but measure stereoacuity over a narrower range compared to the Asteroid which shows less variation on repeated testing but has a larger testing range. The data reported here show varying degrees of agreement in a cohort of visually normal participants, and further investigation is required to determine if there is further variability when stereoacuity is reduced.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229975","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}

{"title":"A population-level post-screening treatment cost framework to help inform vision screening choices for children under the age of seven.","authors":"Anna Horwood, Eveline Heijnsdijk, Jan Kik, Frea Sloot, Jill Carlton, Helen J Griffiths, Huibert J Simonsz","doi":"10.1080/09273972.2023.2268128","DOIUrl":"10.1080/09273972.2023.2268128","url":null,"abstract":"<p><strong>Purpose/background: </strong>Visual acuity (VA) screening in children primarily detects low VA and amblyopia between 3 and 6 years of age. Photoscreening is a low-cost, lower-expertise alternative which can be carried out on younger children and looks instead for refractive amblyopia risk factors so that early glasses may prevent or mitigate the conditions. The long-term benefits and costs of providing many children with glasses in an attempt to avoid development of amblyopia for some of them needs clarification. This paper presents a framework for modeling potential post-referral costs of different screening models once referred children reach specialist services.</p><p><strong>Methods: </strong>The EUSCREEN Screening Cost-Effectiveness Model was used together with published literature to estimate referral rates and case mix of referrals from different screening modalities (photoscreening and VA screening at 2, 3-4 years and 4-5 years). UK 2019-20 published National Health Service (NHS) costings were used across all scenarios to model the comparative post-referral costs to the point of discharge from specialist services. Potential costs were compared between a) orthoptist, b) state funded ophthalmologist and c) private ophthalmologist care.</p><p><strong>Results: </strong>Earlier VA screening and photoscreening yield higher numbers of referrals because of lower sensitivity and specificity for disease, and a different case mix, compared to later VA screening. Photoscreening referrals are a mixture of reduced VA caused by amblyopia and refractive error, and children with amblyopia risk factors, most of which are treated with glasses. Costs relate mainly to the secondary care providers and the number of visits per child. Treatment by an ophthalmologist of a referral at 2 years of age can be more than x10 more expensive than an orthoptist service receiving referrals at 5 years, but outcomes can still be good from referrals aged 5.</p><p><strong>Conclusions: </strong>All children should be screened for amblyopia and low vision before the age of 6. Very early detection of amblyopia refractive risk factors may prevent or mitigate amblyopia for some affected children, but population-level outcomes from a single high-quality VA screening at 4-5 years can also be very good. Total patient-journey costs incurred by earlier detection and treatment are much higher than if screening is carried out later because younger children need more professional input before discharge, so early screening is less cost-effective in the long term. Population coverage, local healthcare models, local case-mix, public health awareness, training, data monitoring and audit are critical factors to consider when planning, evaluating, or changing any screening programme.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693791","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}

{"title":"Comparison between bupivacaine injection and mini-tenotomy in the management of horizontal small angle strabismus in children.","authors":"Wahj N Al-Saeed, Hala M Elhilali, Ahmed M Kamal, Rania S Mohammad, Rasha H Zedan","doi":"10.1080/09273972.2023.2248196","DOIUrl":"10.1080/09273972.2023.2248196","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcome of bupivacaine (BUP) injection vs mini-tenotomy of extra-ocular muscles in treating small angle horizontal strabismus in children.</p><p><strong>Methods: </strong>A prospective comparative study that included a total of 40 patients. Twenty patients received 3 ml of 0.75% Bupivacaine (BUP) injection in both medial recti in case of exotropia and in both lateral recti in case of esotropia. MRI orbit was performed before and 30-60 days' post injection of bupivacaine to estimate changes in muscle size. Mini-tenotomy was done in the other 20 patients, performed on both lateral recti in case of exotropia and on both medial recti in case of esotropia.</p><p><strong>Results: </strong>Mean change of alignment at the end of 6 months in exotropic patients in bupivacaine group was 5.50 ± 4.10 PD and in esotropia patients 4.00 ± 3.38 PD with an average increase in muscle thickness of 0.12 mm ± 0.08 and 0.13 mm ± 0.09 in exotropia and esotropia, respectively. There was an average increase in volume 23 mm³ ± 17.3 and 17.00 mm³ ± 9.50 in exotropia and esotropia, respectively, as measured with MRI. The mean change of alignment in mini-tenotomy was 5.33 ± 4.12 PD, 5.75 ± 4.95 PD in exotropia and esotropia, respectively.</p><p><strong>Conclusion: </strong>Bupivacaine and mini-tenotomy are safe and effective alternative treatment, that improved eye alignment in 65% of patients with small angle horizontal deviation.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202098","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}

{"title":"A pilot randomized clinical trial comparing muscle transplant versus hang back recession in extra-large angle exotropia.","authors":"Amar Pujari, Sujeeth Modaboyina, Rajeswari Thangavel, Deeksha Rani, Sudarshan K Khokhar","doi":"10.1080/09273972.2023.2239299","DOIUrl":"10.1080/09273972.2023.2239299","url":null,"abstract":"<p><strong>Purpose: </strong>For extra-large angle exotropia (>60 prism diopters, PD), single-setting surgical alternatives are scarce; frequently, more than two muscle or two eye procedures are indicated. To evaluate the viability of single eye surgery, a current randomized comparative trial is undertaken.</p><p><strong>Methods: </strong>Twenty adult patients with extra-large angle exotropia underwent a thorough orthoptic evaluation before being divided into two groups at random. Ten patients in group 1 underwent medial rectus resection (5.5-7.5 mm), followed by transplant-aided lateral rectus recession (effective length: 4-5.5 mm) (9 mm). In group two, ten different patients underwent medial rectus resection (5.5-7 mm), but this time, the lateral rectus recession (9 mm) was aided with a hang-back suture (5-7 mm). The two procedures were compared at baseline and six months post-operatively.</p><p><strong>Results: </strong>There was no significant difference in the groups' median ages (<i>P</i> = .95). In groups one and two, the median corrections achieved were 81.00 (79.50-85.50) PD and 81.00 (79.75-86.50) PD, respectively. The differences in corrections were statistically insignificant (<i>p</i> = .99). In all patients, abduction limitation was frequently noted in the immediate post-operative period, which improved over time. In each group, there were two patients (>90 prisms) with residual deviation of at least 30 PD, for which the contralateral eyes were operated.</p><p><strong>Conclusions: </strong>The hang-back recession was as successful as muscle transplant procedure in correcting 80-90 PD of exotropia with notable clinical benefits and ease.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925201","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}

{"title":"Comparison of current paediatric contrast sensitivity assessments using simulated reduced contrast thresholds.","authors":"Paula Amores Morillo, Ashli Milling, Anna O'Connor","doi":"10.1080/09273972.2023.2250393","DOIUrl":"10.1080/09273972.2023.2250393","url":null,"abstract":"<p><strong>Purpose: </strong>There are limited tests of contrast sensitivity (CS) for use in children. The Hiding Heidi (HH) is suitable for all cognitive abilities, but has a ceiling effect. The Double Happy (DH) test has comparable thresholds to the Pelli Robson (PR), however the ability to detect changes in contrast has not been established. This study aims to compare contrast thresholds and agreement between HH and the DH, comparing to the PR chart in normal conditions and under reduced visual and lighting conditions.</p><p><strong>Methods: </strong>Tests were repeated under different conditions to reduce the contrast. Room illumination was 20,900{plus minus}2% lux in bright conditions and 2,000{plus minus}2% lux in dim conditions, both conditions were repeated with the addition of simulation spectacles to reduce the clarity of vision. Participants' CS was measured uniocularly using the PR, HH and DH tests.</p><p><strong>Results: </strong>50 participants, age 18-62 years (mean{plus minus}standard deviation: 24.5{plus minus}7.98), were assessed. On HH 94% (<i>n</i> = 47) reached the maximum score, with the DH it was 18% (<i>n</i> = 9). The difference in reduction between conditions was smaller with HH in comparison to PR and DH, but significantly different from baseline conditions. Under dim conditions the reduction in PR and DH was -0.21 logCS units, but only -0.04 logCS for HH.</p><p><strong>Conclusion: </strong>The DH test has better agreement with PR than HH and is better at detecting CS changes, highlighting the advantages of use in clinical practice.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106226","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}

{"title":"Pulled-in-two syndrome in strabismus surgery for congenital fibrosis of the extraocular muscles.","authors":"Didem Dizdar Yigit,&nbsp;Aslı İnal,&nbsp;Ceren Gürez,&nbsp;Birsen Gokyigit","doi":"10.1080/09273972.2023.2231032","DOIUrl":"10.1080/09273972.2023.2231032","url":null,"abstract":"<p><p><i>Purpose:</i> The aim of this study is to present six cases of pulled-in-two syndrome (PITS) in strabismus surgeries and to discuss our prevention and management strategies. <i>Methods:</i> This is a retrospective study presenting cases of PITS during strabismus operations. The medical records of the subjects who underwent operation in the strabismus unit of Beyoglu Eye Training and Research Hospital were reviewed retrospectively, from January 2000 till March 2022. Detailed ophthalmological examination records and angle of deviation were noted. <i>Results:</i> A total of six cases (four males and two females) with a mean age of 37.2 ± 28.0 (min 9-max 71) years were included in this study. All of the cases had congenital fibrosis of extraocular muscles (CFEOM). The most commonly involved muscle was medial rectus (83%). Majority of cases (67%) were adults. In all cases, the muscle was found and reattached to the globe. No patients had diplopia after surgery. <i>Conclusion:</i> PITS is a rare complication that can be seen during strabismus surgeries, and CFEOM patients are in the risk group. Therefore, surgeons should be cautious and prepared in risky patients to be able to manage this complication.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274166","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}