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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine patients underwent simultaneous or staged detachment of the vertical and medial rectus muscles in the treatment of sixth nerve palsy or Duane's retraction syndrome. In five adult patients (34, 35, 41, 45, and 65 years of age), clinically significant anterior segment ischemia developed postoperatively. Known medical risk factors were present in only one case. With the exception of corectopia, there were no apparent sequelae and all involved eyes returned to preoperative visual acuity within 9 weeks of surgery. Anterior segment ischemia may be a frequent complication of strabismus surgery in adult patients when the superior, inferior, and medial rectus muscles are detached from the globe.
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PMID:Anterior segment ischemia after three rectus muscle surgery. 317 12

Anterior segment ischemia developed in a 62-year-old dysthyroid patient after two-muscle adjustable suture repair of vertical strabismus. Because of a quiescent pulmonary tuberculous focus he was not treated with systemic steroid therapy but rather with hyperbaric oxygen in the controlled environment of our hospital hyperbaric chamber. He tolerated this treatment well, and his acute symptoms almost completely resolved in 3 days. We believe this to be the first reported case of the use of hyperbaric oxygen in the management of anterior segment ischemia. We also believe it is the first reported case of anterior segment ischemia following surgery to two opposing, not contiguous, rectus muscles in dysthyroid ophthalmopathy.
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PMID:Anterior segment ischemia treated with hyperbaric oxygen. 343 55

Ischemia of the anterior segment of the eye is rare but may be in relation with some strabismic procedures. The physiopathology is unclear. This experimental data on human cadaver studied the arterial vascularization of the major circle of iris with injection and opacification of an aqueous suspension of barium. The respective participation of anterior ciliary arteries and long posterior ciliary arteries, respectively were analysed. Some recti muscles were cut with various combinations and before injection. The breaks of the major arterial circle which resulted were noticed. They were large when both vertical recti were cut and minimal or absent when both horizontal recti were cut. The anterior ciliary arteries coming from interior and superior rectus are very important. The long posterior ciliary arteries seem to be more important than the anterior ciliary arteries coming from both horizontal recti muscles and especially the medial long posterior ciliary artery. Our study provides an explanation of classical iatrogenic iridociliary ischemia following Hummelsheim or O'Connors strabismus procedure.
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PMID:[Arterial vascularization and ischemia of the anterior eye segment. Experimental radio-anatomical study of human cadavers]. 345 Jul 4

Two cases of strabismus fixus are described. Histopathological examination of the eyeballs from both patients revealed the following complications of this rare disorder: ocular ischemia, atrophy of the optic nerve, and old central retinal artery occlusion. These complications are likely to be secondary to the mechanical stretching and torsion of the optic nerve with subsequent strangulation of its blood supply. Early surgical correction of strabismus fixus is recommended.
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PMID:Ocular complications in strabismus fixus convergens. 369 3

We studied the arterial vascularization of the anterior segment of 25 cadaver eyes. Arteries had been opacified by an injection of an aqueous suspension of barium. Our study has focused on the anterior ciliary arteries (ACA), emerging from the four rectus muscles. Among the numerous individual variations, we have noticed the following predominant aspects: for the external rectus muscle, the ACA is usually unique and thin, located in the superior or inferior third of the muscle. For the others rectus muscles, the ACA are rather big and frequently observed in pairs. They tend to be found on each lateral side of the muscle. By and large, the vertical ACA look bigger and more numerous than the horizontal ACA. The number, the size and the position of the long posterior ciliary arteries are quite uniform. The major arterial circle of the iris seems to be discontinuous, and is more and less made of arterial anastomoses. This study enabled us to reconsider the usual anatomical description of arterial supply of the anterior segment. The vascularization by the ACA, especially at the level of the inferior and superior rectus muscle, has to be known in order to avoid an anterior segment ischemia following strabismus surgery.
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PMID:[Arterial supply to the anterior segment of the eye. Radioanatomical study of a series of 25 human eyes]. 383 85

Anterior segment ischemia (ASI) is a potentially blinding complication of extensive eye muscle surgery. Eyes have been described with this complication following surgery on as few as two rectus muscles, especially in patients with thyroid dysfunction or other medical illnesses. In an attempt to assess the risk of ASI, we have reviewed the records of 34 eyes in 26 patients who underwent surgery on three or four rectus muscles. Seven eyes of six patients with thyroid ophthalmopathy which underwent two-or three-muscle surgery were also studied. Evidence of clinically significant ASI was apparent in only one patient during a follow-up period of seven months to eleven years. This case was mild and no visual loss resulted. Our findings suggest that surgery on three or four rectus muscles in healthy patients is probably safe when performed in a staged fashion.
J Pediatr Ophthalmol Strabismus
PMID:Anterior segment ischemia following strabismus surgery. 650 7

Two patients developed clinically significant anterior segment ischemia following full tendon transposition of the superior and inferior recti muscles nine and 20 years after they underwent horizontal rectus muscle surgery. Ipsilateral carotid artery ligation in one patient and possible hyperlipoproteinemia type II in the other were discovered postoperatively and may have contributed to the circulatory disturbances observed. In adult patients with paretic strabismus, the most important function of the paretic muscle may be maintenance of circulation to the anterior segment of the eye.
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PMID:Anterior segment ischemia syndrome following rectus muscle transposition. 706 85

Surgery on the extraocular muscles of the eye is generally consisted a safe procedure which is associated with low morbidity and mortality. While infrequent, intra-operative complications occasionally occur. Tenotomy of multiple rectus muscles can result in interruption of the vascular supply to the anterior segment of the eye. Anterior segment ischemia (ASI) may result. This article reviews the complication of anterior segment ischemia as a result of strabismus surgery and its potential for producing permanent visual loss.
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PMID:Anterior segment ischemia after strabismus surgery. 800 29

Esotropia from chronic sixth nerve palsy or paresis usually requires surgery. Chemodenervation of the antagonist medial rectus muscle, while popular for the treatment of acute sixth nerve palsies and pareses, has not been used extensively for chronic cases. In this study, 22 patients with sixth nerve palsies or partially recovered palsies of greater than 5 months duration were treated with chemodenervation. The etiologies of the sixth nerve palsies were trauma (n = 7), tumor (n = 4), infection/inflammation (n = 3), nerve compression from aneurysm or increased intracranial pressure (n = 4), congenital (n = 1), ischemia (n = 2), and idiopathic (n = 1). The mean preinjection deviation was 41 prism diopters. A total of 38 injections were administered (mean, 1.7 per patient). Each patient received an injection of 2.5 to 7.5 units (mean, 4.1) of botulinum neurotoxin A to the ipsilateral medial rectus muscle. Treatment success was assessed 6 months after the last injection. A course of chemodenervation significantly improved the alignment of 9 of the 22 patients (41%). The mean postinjection deviation was 8 delta. Seven patients (32%) had single binocular vision in primary position restored. These patients had a mean horizontal binocular field of 70 degrees (range, 40 degrees to 100 degrees). Thirteen patients (59%) had only modest improvement and required surgery. The data suggest that injection of botulinum neurotoxin A is a useful treatment for some patients with chronic sixth nerve weakness. A course of chemodenervation therapy compares less favorably with transposition surgery with concomitant neurotoxin injection for the treatment of these difficult problems.
J Pediatr Ophthalmol Strabismus
PMID:The efficacy of botulinum neurotoxin A for the treatment of complete and partially recovered chronic sixth nerve palsy. 771 9

We present tyndallometry as a method for investigation of subclinical changes in anterior-chamber flare in patients with risk factors regarding anterior-segment ischemia after squint surgery. The cases of six adult patients who underwent surgery on the vertical recti and who had additional risk either because of dysthyroid orbitopathy or because of transpositions carried out on the recti are presented. In one case a transient subclinical increase in the flare value was observed. This noninvasive method seems suitable for the provision of further information on the pathophysiology of anterior-segment ischemia and for monitoring of patients at special risk postoperatively such that early treatment can be started if necessary. Additionally, early detection of nonischemic intraocular inflammation in the postoperative course is rendered possible by this examination.
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PMID:The influence of strabismus surgery on the blood-aqueous barrier: tyndallometry case studies in patients with risk factors. 947 16


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