Uveal effusion syndrome after strabismus surgery

CASE REPORT: A woman was operated on for strabismus under topical anesthesia. An exudative conjunctivitis was diagnosed immediately after the surgery, and a uveal effusion syndrome diagnosed 15 days later. Surgery exploration, vycril suture removal and therapy with systemic, sub-tenon, and topical corticosteroid and antibiotics was initiated. Intraoperative culture revealed evidence of Staphylococcus epidermidis. Good resolution occurred in 4 months. DISCUSSION: Uveal effusion secondary to strabismus surgery has not been reported in the published literature. Implant and suture infection by Staphylococcus epidermidis following scleral buckling surgery may be a possible, but rare, cause of the uveal effusion syndrome.     

斜视术后并发复视555例临床分析

目的 探讨斜视矫正术后复视的发生情况.方法 回顾性系列病例研究.回顾分析1999年1月至2009年12月西安市中心医院眼科收治的5900例斜视矫正手术病例,对斜视术后并发复视的发生率、手术年龄、斜视类型进行分析,并总结手术原则和方案设计思路.结果 手术方案设计：①儿童内斜、外斜手术做到角膜映光正位,保留少量内隐斜;②成人内斜视手术做到角膜映光正位,保留少量内隐斜,不要过矫;③成人外斜视手术做到角膜映光正位,保留少量外隐斜,不要过矫;④获得性麻痹性斜视手术量宁欠勿过;⑤垂直斜视均做到少量欠矫为宜;⑥成人超过40°以上的大角度外斜视,术后保留5°外斜视,外观较满意;⑦一条肌肉不要承担过大的手术量,以避免引起眼球运动受限,造成非共同性斜视,向肌肉运动方向出现复视.术后常规用同视机进行双眼单视功能训练.5900例斜视手术病例中,术后仅有555例（9.41%）患者诉复视,其中短暂性复视患者552例（9.36%）,复视症状分别于术后3 d、1周或1个月完全消失;持续性复视患者有3例（0.05%）,术后复视症状持续半年或两年半不等.共同性外斜视术后复视的发生率较高,达12.58%（433/3443）,占总发生率的78.02%.年龄对复视的发生率影响不大.结论 斜视术后复视不可避免,一般以短暂性复视为主,只要手术设计合理,术后经 同视机训练后均能消失,持续性复视的发生率极低.     

Consecutive strabismus after infantile nystagmus syndrome surgery and potential risk factors

Graefe's Archive for Clinical and Experimental Ophthalmology - The aim of this study is to evaluate the incidence of consecutive strabismus after infantile nystagmus surgery and its potential...     

斜视手术术后屈光状态的变化

目的探讨不同斜视手术术后矫正视力、屈光状态随时间的变化。方法前瞻性临床研究。选择2013年12月16日至2014年8月13日于北京同仁医院行斜视矫正术的患者133例（194眼）。根据手术方式不同分为4组：1 组为一条直肌后退术（63例102 眼）;2 组为一条直肌后退联合一条直肌截除术（19例27眼）;3 组为一条直肌后退联合一条直肌改良线状折叠术（40例50 眼）;4 组为一条直肌后退联合一条斜肌后退术（11例15 眼）。采用两因素重复测量方差分析对各组术前,术后1、3、6个月术眼的矫正视力和屈光状态进行比较。术前与术后1、3、6个月散光类型的比较采用χ²检验。结果术前1、2、3、4组最佳矫正视力（BCVA）、等效球镜度（SE）、散光度差异均无统计学意义。4组患者矫正视力、SE比较显示组间、各时间点差异均无统计学意义。4组患者散光度比较显示组间差异无统计学意义,组内各时间点差异有统计学意义（F=30.50,P＜0.001）,进一步两两比较显示4组散光度术后1、3个月均较术前增加（P＜0.05）,术后6个月散光度与术前、术后1个月、术后3个月相比有所下降,但差异均无统计学意义。术前与术后1、3、6个月散光眼比例分别为57%、73%、76%、62%,与术前相比,术后1个月和3个月散光眼比例明显增加,差异有统计学意义（χ²=20.29、19.80,P＜0.001）,其中以顺规散光增加为主,术后6个月散光眼比例与术前差异无统计学意义。结论斜视手术对术眼的矫正视力无影响,对散光度存在一定影响,但在6个月内多可恢复到术前水平。不同术式对术后矫正视力和屈光状态变化无影响。     

Long-term results after strabismus surgery

The results of surgery after 4 years' or more postoperative follow-up have been evaluated in a total of 1031 cases (575 esotropia, 456 exotropia). There is a difference in the angle of strabismus 1 month after surgery and 4 years after surgery. Based on these findings, the results of strabismus surgery must be evaluated after a sufficient amount of time has passed. The angle of strabismus to be aimed at, to provide best binocular vision and patient satisfaction, should be in the range of –2 +7 degree for esotropia and +2 –10 degree for exotropia, regardless of the patient's age at surgery.Dedicated to Dr. G.K. von Noorden on the occasion of his 60th birthday     

Hemodynamic changes after strabismus surgery

AIM: The aim of this study was to investigate the hemodynamic changes that may occur in the retrobulbar circulation after strabismus surgery, using color Doppler ultrasonography (CDI). METHODS. Fifteen healthy volunteers (control group, n=15) and sixteen patients diagnosed with strabismus were enrolled in the study. Either recession or resection was planned on one horizontal rectus muscle in the eyes of Group 1 (n=11) and on two horizontal rectus muscles in the eyes of Group 2 (n=10). CDI was performed to measure peak systolic velocity (V max ), end-diastolic velocity (V min ) and mean blood flow velocity (V mean ) in the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) in the control group and in Groups 1 and 2, both preoperatively and 2-7 days postoperatively. RESULTS. The postoperative resistivity indexes in Groups 1 and 2 were found to be different from those in the control group. Preoperative V max and postoperative V min and V mean values of the vessels in Group 2 were different from those in both Group 1 and the control group (p<0.001). In both treatment groups, the differences between postoperative and preoperative measurements of the parameters in the OA, CRA and PCA demonstrated statistical significance (p<0.001). CONCLUSION. After strabismus surgery on the horizontal recti, there are some alterations in the retrobulbar blood flow with a significant difference between pre- and postoperative blood flow velocities after single and double rectus surgery. The clinical significance of these results needs to be determined because CDI may be a useful tool in the investigation of hemodynamic alterations after anterior segment interventions that may cause anterior segment ischemia.     

Formaldehyde-induced keratopathy after strabismus surgery

We report on a patient who developed corneal haze and permanent ptosis after strabismus surgery. Formaldehyde-disinfected sodium hyaluronate which was used to protect the corneal epithelium during surgery was thought to have induced keratopathy and other findings. To our knowledge, this is the first report of corneal haze formation together with ptosis secondary to formaldehyde toxicity as a complication of strabismus surgery.     

斜视术后屈光状态的动态分析

目的 观察水平斜视及垂直斜视术后屈光状态变化及不同术式对屈光状态的影响.方法 通过睫状肌麻痹验光和角膜地形图检查,对40例水平斜视及42例垂直斜视患者术前、术后1、4、8周的屈光状态动态分析.结果 下斜肌转位组术后球镜及柱镜变化均无统计学意义,P ＞0.05.单眼一条直肌后徙组睫状肌麻痹后柱镜变化术后1周与术前比较有统计学意义(P＜0.05).单眼一退一截组睫状肌麻痹后球镜变化在1周与术前比较有统计学意义(P＜0.05),柱镜变化及角膜地形图dk值变化术后1、4周均与术前比较差异有统计学意义(P＜0.05).角膜地形图曲率变化:后徙侧角膜3 mm、5 mm区角膜曲率增大,而截除侧变小,术后1、4周与术前比较差异有统计学意义,(P＜0.05).结论 不同术式对眼球屈光状态影响持续时间不同,但均可恢复.     

垂直斜视术后屈光状态的动态分析

目的了解斜视术后眼球屈光状态的动态变化及不同术式对屈光状态的影响,并对其发生机理进行初步探讨。方法用散瞳验光和角膜地形图检查,对35例垂直斜视进行手术前后屈光状态的动态分析。结果斜肌手术对眼球屈光状态无影响,上直肌后徙术可使上方角膜变陡峭,但对鼻、下、颞侧角膜及散光度无影响。上直肌后徙术及下直肌截除术对上、下侧角膜及散光度的影响有显著性差异(P<0．01)。结论斜视手术对眼球屈光状态的影响是可恢复的,不同术式所需恢复的时间不同。     

Pointing response before and after strabismus surgery

Eye-hand open-loop pointing responses were measured in eight patients before and after unilateral strabismus surgery. They showed large shifts in pointing responses with the operated eye and relatively small ones with the non-operated eye. The same pointing responses were examined in five normal subjects. Statistically significant shifts were found even in cases of normal subjects. From these results, it was speculated that visual localization and eye-hand coordination may change by some unknown factors or under casual conditions.     

Prognostic factors for strabismus surgery after cataract surgery

PURPOSE: To evaluate the clinical features of strabismus that present after cataract surgery and determine the motor and sensory results after surgical correction of the strabismus. SETTING: Department of Ophthalmology, the Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. METHODS: Thirty-one patients who had strabismus surgery after cataract surgery between January 1996 and June 2004 were included in the study. The clinical features of strabismus and the factors contributing to successful strabismus surgery results were retrospectively analyzed. Sensory functional tests were performed postoperatively. RESULTS: Fifteen patients (48.4%) had exotropia. The types of cataract included traumatic (35.5%), congenital (32.3%), and senile (25.8%). Prolonged deviation was the statistically significant factor contributing to final alignment (P = .023). Fourteen of 31 patients had stereoacuity measurement; all achieved a stereoacuity of 3000 seconds of arc. Five of the 14 patients (35.7%) had better than 200 seconds of arc. CONCLUSIONS: The anatomical results and sensory function of the patients were generally good. When appropriate, surgical intervention to treat strabismus after cataract surgery should be offered, and this is important for restoration of fusion.     

Persistent strabismus presenting after cataract surgery

To determine causative factors of persistent strabismus presenting after cataract surgery, the surgical techniques and subsequent motility findings of eight patients who had persistent postoperative strabismus were studied. In two of the eight patients, complications related to the placement of the bridle suture were believed causative based on subsequent surgical findings. A similar etiology could be speculated in an additional three patients. An isolated vascular accident coincident to the cataract operation could account for a sixth case. The final two patients were believed to have a decompensated congenital fourth nerve palsy. In no patients could the myotoxic effect of a local anesthetic or the hypoxic effect of an ocular pressure-reduction device plausibly account for the deviation.