Topical anaesthesia in strabismus surgery for Graves’ orbitopathy: a comparative study of 111 patients

2021 ◽  
Author(s):  
Lena Boulakh ◽  
Anne Pernille Toft‐Petersen ◽  
Martin Severinsen ◽  
Peter Bjerre Toft ◽  
Christina Ellervik ◽  
...  
Keyword(s):  
Comparative Study ◽  
Strabismus Surgery ◽  
Topical Anaesthesia ◽  
Graves Orbitopathy

scholarly journals Tendon elongation with bovine pericardium in strabismus surgery—indications beyond Graves’ orbitopathy

2020 ◽  
Vol 259 (1) ◽  
pp. 145-155
Author(s):  
Andrea Hedergott ◽  
Ursula Pink-Theofylaktopoulos ◽  
Antje Neugebauer ◽  
Julia Fricke
Keyword(s):  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Bovine Pericardium ◽  
Prism Diopter ◽  
Type I ◽  
Retraction Syndrome ◽  
Tendon Elongation ◽  
Graves Orbitopathy ◽  
Duane’S Retraction Syndrome

Abstract Background For some patients with complex ocular motility disorders, conventional strabismus surgery is insufficient. Surgery with tendon elongation allows correction of larger angles and maintains a sufficient arc of contact for rectus muscles. This study reports results for tendon elongation with bovine pericardium (Tutopatch®) in indications other than Graves’ orbitopathy in which it is already widely used. Methods We reviewed the records of all patients who underwent surgery with Tutopatch® in our institution. Angles of squint and head postures were analyzed preoperatively, on the first postoperative day, and in the long term (median 9 weeks after the operation). Patients with Graves’ orbitopathy were excluded. Results From 2011 to 2018, the procedures on 58 eyes of 54 patients (35 females, median age 35 years (3–75)) met the inclusion criteria. Horizontal rectus muscle surgery (53 eyes) was conducted on patients with residual strabismus (13), Duane’s retraction syndrome with eso- (type I: 16)/exodeviation (type II: 2, type III: 1), 6th (7)/3rd nerve palsy (7), Möbius syndrome (2), congenital fibrosis of the extraocular muscles type 3A (CFEOM3A, TUBB3 mutation) (4), and orbital apex syndrome (1). Vertical rectus muscle surgery (5 eyes) was conducted on patients with myasthenia (1), vertical tropia after orbital floor fracture (1), CFEOM1 (2), and Parry-Romberg syndrome (1). 42 eyes had prior eye muscle surgery (1–5 procedures, median 1). Out of 45 patients with postoperative long-term data, 43 showed an angle reduction. Fifty-one percent had an angle of 10Δ (prism diopter) or less, one had a significant over-effect, and 10 had revision surgery. For the heterogeneous group of residual eso- and exotropias, the median absolute horizontal angle was reduced from 35Δ (16 to 45Δ) to 9Δ (0 to 40Δ), for Duane’s retraction syndrome from 27.5Δ (9 to 40Δ) to 7Δ (0 to 40Δ), and for sixth and third nerve palsies from 43Δ (20 to 75Δ) to 18Δ (4 to 40Δ). For 3 patients with vertical rectus muscle surgery, the median absolute vertical angle was reduced from 30Δ (20 to 45Δ) to 4Δ (1 to 22Δ). The motility range was shifted in the direction contrary to the elongated muscle in all subgroups. A considerable reduction of the excursion into the field of action of the elongated muscle had to be registered. Conclusions Strabismus surgery with bovine pericardium introduces new surgical options for complicated revisions and for rare and complex oculomotor dysfunctions. Yet, it has to be recognized that this type of surgery aiming at maximum effects, despite preservation or restitution of the arc of contact, leads to reduction of the excursion into the field of action of the elongated muscle. Furthermore, dose finding can be difficult depending on the underlying pathology and more than one intervention might be necessary for optimal results.

scholarly journals Quality of life improves after strabismus surgery in patients with Graves' orbitopathy

2014 ◽  
Vol 170 (5) ◽  
pp. 785-789 ◽  
Author(s):  
Hinke Marijke Jellema ◽  
Elly Merckel-Timmer ◽  
Roel Kloos ◽  
Peerooz Saeed ◽  
Maarten P Mourits
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Case Series ◽  
Strabismus Surgery ◽  
Weak Correlation ◽  
Visual Functioning ◽  
Single Vision ◽  
Graves Orbitopathy ◽  
Binocular Single Vision

ObjectiveTo evaluate the influence of strabismus surgery on quality of life (QoL) in Graves' orbitopathy (GO) patients.DesignProspective study of case series.MethodsConsecutive GO-patients who were scheduled for their first strabismus surgery were included in the study. The patients completed the GO-QoL questionnaire within 3 months before the surgery and 2–4 months after the surgery. A complete orthoptic examination, including the field of binocular single vision (BSV), was performed. Clinically relevant response (CRR) in the QoL was also evaluated.ResultsIn this study, 28 patients were included. The GO-QoL score for visual functioning was 46.3±24.2 before surgery and 65.7±30.5 after surgery (P=0.009). The GO-QoL score for appearance changed from 60.6±25.9 to 69.5±24.2 (P=0.005). After surgery, the field of BSV increased from 24.3±34.8 to 68.5±36.0 points (P=0.000). A weak correlation was found between the field of BSV and the visual functioning score after surgery (r=0.417; P=0.034). CRR was found in 20 (71%) patients. Those with a CRR showed a larger field of BSV (P=0.002) and better GO-QoL scores (P=0.008).ConclusionsGO-QoL score increases significantly for both visual functioning and appearance after the first strabismus surgery in GO-patients, showing the highest improvement for the visual functioning questions. Both the GO-QoL and field of BSV outcomes correlate well with the CRR.

A Comparative Study of Full-Thickness Blepharotomy Versus Transconjunctival Eyelid Lengthening in the Correction of Upper Eyelid Retraction in Graves’ Orbitopathy

2017 ◽  
Vol 42 (1) ◽  
pp. 215-223
Author(s):  
Allan C. Pieroni Gonçalves ◽  
Thiago Nogueira ◽  
Ana Carolina Arato Gonçalves ◽  
Luzia Diegues Silva ◽  
Suzana Matayoshi ◽  
...  
Keyword(s):  
Comparative Study ◽  
Full Thickness ◽  
Eyelid Retraction ◽  
Upper Eyelid ◽  
Upper Eyelid Retraction ◽  
Graves Orbitopathy

scholarly journals Proposal of success criteria for strabismus surgery in patients with Graves' orbitopathy based on a systematic literature review

2015 ◽  
Vol 93 (7) ◽  
pp. 601-609 ◽  
Author(s):  
Hinke Marijke Jellema ◽  
Yvette Braaksma-Besselink ◽  
Jacqueline Limpens ◽  
Georg von Arx ◽  
Wilmar M. Wiersinga ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Strabismus Surgery ◽  
Success Criteria ◽  
Graves Orbitopathy

scholarly journals THU0560 DISTINCTIVE IMAGING FEATURES BETWEEN IGG4-RELATED OPHTHALMIC DISEASE AND GRAVES’ ORBITOPATHY: A COMPARATIVE STUDY

2019 ◽  
Author(s):  
Eduardo Martin-Nares ◽  
Oziel Amaya-Piña ◽  
Rosa Delia Delgado-Hernández ◽  
Gabriela Hernandez-Molina
Keyword(s):  
Comparative Study ◽  
Imaging Features ◽  
Graves Orbitopathy ◽  
Ophthalmic Disease
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