scholarly journals Combined Rectus Muscle Transposition With Posterior Fixation Sutures (Augmented Knapp Procedure) for the Surgical Treatment of Double Elevator Palsy

Author(s):  
Serpil Akar ◽  
Birsen Gokyigit ◽  
Zeynep Kayaarasi Ozturker
Ophthalmology ◽  
2005 ◽  
Vol 112 (5) ◽  
pp. 933-938 ◽  
Author(s):  
M SNIR ◽  
R FRILING ◽  
H KALISHSTIEBEL ◽  
D BOURLA ◽  
D WEINBERGER ◽  
...  

Ophthalmology ◽  
2005 ◽  
Vol 112 (5) ◽  
pp. 939-943 ◽  
Author(s):  
M SNIR ◽  
R FRILING ◽  
H KALISHSTIEBEL ◽  
I SHERF ◽  
D WEINBERGER ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed F. Farid ◽  
Ahmed E. M. Daifalla ◽  
Mohamed A. Awwad

Abstract Background Superior rectus muscle transposition (SRT) is one of the proposed transposition techniques in the management of defective ocular abduction secondary to chronic sixth nerve palsy and esotropic Duane retraction syndrome (Eso-DRS). The aim of the current study is to report the outcomes of augmented SRT in treatment of Eso-DRS and chronic sixth nerve palsy. Methods a retrospective review of medical records of patients with Eso-DRS and complete chronic sixth nerve palsy who were treated by augmented full tendon SRT combined with medial rectus recession (MRc) when intraoperative forced duction test yielded a significant contracture. Effect on primary position esotropia (ET), abnormal head posture (AHP), limitation of ocular ductions as well as complications were reported and analyzed. Results a total of 21 patients were identified: 10 patients with 6th nerve palsy and 11 patients with Eso-DRS. In both groups, SRT was combined with ipsilateral MRc in 18 cases. ET, AHP and limited abduction were improved by means of 33.8PD, 26.5°, and 2.6 units in 6th nerve palsy group and by 31.1PD, 28.6°, and 2 units in Eso-DRS group respectively. Surgical success which was defined as within 10 PD of horizontal orthotropia and within 4 PD of vertical orthotropia was achieved in 15 cases (71.4%). Significant induced hypertropia of more than 4 PD was reported in 3 patients (30%) and in 2 patients (18%) in both groups, respectively. Conclusion augmented SRT with or without MRc is an effective tool for management of ET, AHP and limited abduction secondary to sixth nerve palsy and Eso-DRS. However, this form of augmented superior rectus muscle transposition could result in high rates of induced vertical deviation.


Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.


Author(s):  
D.R. Mamulat ◽  
◽  
I.L. Plisov ◽  
N.G. Antsiferova ◽  
M.A. Sharokhin ◽  
...  

Purpose. To evalute the effective of the proposed volume of surgical treatment for the progressive course of infant esotropia. Material and мethods. A premature baby with congenital esotropia, which was diagnosed at the sith month of life. The patient was assigned a spectacle correction taking into account the par of ametropia and constant alternating occlusion. In connection with the subsequent increase in horizontal esodeviation and the appearance of a paretic component, a bilateral recession of the internal rectus muscle by 5mm was carried out in combination with an injection of Botox in a volume of 2.0. IU. Results and discussion. After the first stage of surgical treatment, a stable decrease of horizontal esodeviation and an increase of the amount of abduction were achieved. Conclusion. Bilateral combined weakening of medial rectus muscles (classical recession and chemorecession) allows to achieve predicted good results in case of large strabismus angles, combined with limi of abduction. Key words: congenital esotropia, chemodenervation, chemorecession.


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