PURPOSE: To report a new extraocular muscle surgery procedure for large-angle extorsion, and clinical management of subjective tilt and diplopia after full macular translocation (MT360). Design: Consecutive retrospect...PURPOSE: To report a new extraocular muscle surgery procedure for large-angle extorsion, and clinical management of subjective tilt and diplopia after full macular translocation (MT360). Design: Consecutive retrospective case series. Participants: Seven patients with downward MT360 were evaluated after MT360, both before (preoperative) and after (postoperative) extraocular muscle surgery, with at least 6 months’follow-up. Methods: Information gathered included demographics, visual acuity, ocular motility, torsion by Maddox rod, ocular history, and symptoms of visual disturbance. Surgery on extraocular muscles was performed based on the magnitude of torsion measured after MT360 surgery. Main Outcomes Measures: Maddox rod testing of torsion after MT360, and both preoperative and postoperative extraocular muscle surgery. Results: Mean preoperative torsion was reduced from 45.4±11.3°to 8.3±4.8°(at 6 months after MT360) (P=0.03). Extraocular muscle surgery slightly reduced the mean hypertropia of the operated eye (preoperative, 20±10 prism diopters PD , vs. postoperative, 11±6 PD) (P=0.06). Mean exotropia was affected minimally by extraocular muscle surgery (preoperative, 22±31 PD, vs. postoperative, 20±24 PD). Three patients required a second extraocular muscle surgery (performed on the fellow eye) to correct residual extorsion and diplopia. Overall, 85%(6/7) of patients were free of both diplopia and tilt after 1 or 2 extraocular muscle surgeries. Conclusions: Although our patients continued to have significant horizontal/vertical strabismus postoperatively, the extraocular muscle surgery performed was successful in reducing the torsional misalignment enough such that the remaining diplopia could be successfully ignored or suppressed.展开更多
Central corneal thickness (CCT) has emerged as an important predictive factor for the development of glaucomatous damage. Although a child’ s cornea reaches adult thickness by the age of 3, little has been reported a...Central corneal thickness (CCT) has emerged as an important predictive factor for the development of glaucomatous damage. Although a child’ s cornea reaches adult thickness by the age of 3, little has been reported about normal CCT measurements in eyes of children. We wished to test the hypotheses that (1) there is a correlation between increasing CCT and increasing intraocular pressure (IOP) in the eyes of children, (2) the CCT in the eyes of children with ocular hypertension is greater than that in eyes of normal pediatric subjects, and (3) the average CCT of black children is less than that of white children. We performed a retrospective chart review of 69 pediatric patients seen in the office of one ophthalmologist between January 1997 and December 2001 in whom CCT was measured by ultrasound pachymetry. We categorized the subjects into diagnostic groups of controls, glaucoma, glaucoma suspects, and ocular hypertension based on IOP, cup- to- disc ratio, and visual field parameters. The average CCT for the control patients was 555± 37 μ m; for patients with glaucoma, it was 563± 33 μ m; for glaucoma suspects, 559± 39 μ m; and for those with ocular hypertension, 595± 39 μ m. The difference between the control and ocular hypertensive groups was significant (P < 0.02). The difference in CCT between the black control subjects and the white ones (537± 36 μ m vs. 564± 28 μ m) was not statistically significant (P=0.125). Central corneal thickness is greater in children with ocular hypertension than in control subjects or those with glaucoma, and the values for CCT in these children correlate closely with values reported for adults. Corneas of black children may be thinner than the corneas of white children.展开更多
The development of Lisch nodules in an eye that had undergone trabeculectomywi th mitomycin C is described. Complete ophthalmologic examinations and genetic te sting of a 12-yearold boy were performed. Lisch nodules c...The development of Lisch nodules in an eye that had undergone trabeculectomywi th mitomycin C is described. Complete ophthalmologic examinations and genetic te sting of a 12-yearold boy were performed. Lisch nodules can develop after trabe culectomy without the systemic manifestations of neurofibromatosis type 1.展开更多
文摘PURPOSE: To report a new extraocular muscle surgery procedure for large-angle extorsion, and clinical management of subjective tilt and diplopia after full macular translocation (MT360). Design: Consecutive retrospective case series. Participants: Seven patients with downward MT360 were evaluated after MT360, both before (preoperative) and after (postoperative) extraocular muscle surgery, with at least 6 months’follow-up. Methods: Information gathered included demographics, visual acuity, ocular motility, torsion by Maddox rod, ocular history, and symptoms of visual disturbance. Surgery on extraocular muscles was performed based on the magnitude of torsion measured after MT360 surgery. Main Outcomes Measures: Maddox rod testing of torsion after MT360, and both preoperative and postoperative extraocular muscle surgery. Results: Mean preoperative torsion was reduced from 45.4±11.3°to 8.3±4.8°(at 6 months after MT360) (P=0.03). Extraocular muscle surgery slightly reduced the mean hypertropia of the operated eye (preoperative, 20±10 prism diopters PD , vs. postoperative, 11±6 PD) (P=0.06). Mean exotropia was affected minimally by extraocular muscle surgery (preoperative, 22±31 PD, vs. postoperative, 20±24 PD). Three patients required a second extraocular muscle surgery (performed on the fellow eye) to correct residual extorsion and diplopia. Overall, 85%(6/7) of patients were free of both diplopia and tilt after 1 or 2 extraocular muscle surgeries. Conclusions: Although our patients continued to have significant horizontal/vertical strabismus postoperatively, the extraocular muscle surgery performed was successful in reducing the torsional misalignment enough such that the remaining diplopia could be successfully ignored or suppressed.
文摘Central corneal thickness (CCT) has emerged as an important predictive factor for the development of glaucomatous damage. Although a child’ s cornea reaches adult thickness by the age of 3, little has been reported about normal CCT measurements in eyes of children. We wished to test the hypotheses that (1) there is a correlation between increasing CCT and increasing intraocular pressure (IOP) in the eyes of children, (2) the CCT in the eyes of children with ocular hypertension is greater than that in eyes of normal pediatric subjects, and (3) the average CCT of black children is less than that of white children. We performed a retrospective chart review of 69 pediatric patients seen in the office of one ophthalmologist between January 1997 and December 2001 in whom CCT was measured by ultrasound pachymetry. We categorized the subjects into diagnostic groups of controls, glaucoma, glaucoma suspects, and ocular hypertension based on IOP, cup- to- disc ratio, and visual field parameters. The average CCT for the control patients was 555± 37 μ m; for patients with glaucoma, it was 563± 33 μ m; for glaucoma suspects, 559± 39 μ m; and for those with ocular hypertension, 595± 39 μ m. The difference between the control and ocular hypertensive groups was significant (P < 0.02). The difference in CCT between the black control subjects and the white ones (537± 36 μ m vs. 564± 28 μ m) was not statistically significant (P=0.125). Central corneal thickness is greater in children with ocular hypertension than in control subjects or those with glaucoma, and the values for CCT in these children correlate closely with values reported for adults. Corneas of black children may be thinner than the corneas of white children.
文摘The development of Lisch nodules in an eye that had undergone trabeculectomywi th mitomycin C is described. Complete ophthalmologic examinations and genetic te sting of a 12-yearold boy were performed. Lisch nodules can develop after trabe culectomy without the systemic manifestations of neurofibromatosis type 1.
