BACKGROUND Inferior oblique anterior transposition(IOAT)has emerged as an effective surgery in the management of dissociated vertical deviation(DVD)combined with superior oblique palsy(SOP).Traditional IOAT usually pr...BACKGROUND Inferior oblique anterior transposition(IOAT)has emerged as an effective surgery in the management of dissociated vertical deviation(DVD)combined with superior oblique palsy(SOP).Traditional IOAT usually provides satisfactory primary position alignment and simultaneously restricts the superior floating phenomenon.However,it also increases the risk of the anti-elevation syndrome and narrowing of the palpebral fissure in straight-ahead gaze,especially after the unilateral operation.CASE SUMMARY We report the outcomes of the modified unilateral IOAT in two patients with unilateral DVD combined with SOP.The anterior-nasal fibers of the inferior oblique muscle were attached at 9 mm posterior to the corneal limbus along the temporal board of the inferior rectus muscle,the other fibers were attached a further 5 mm temporal to the anterior-nasal fibers.Postoperatively,both hypertropia and floating were improved,and no obvious complications occurred.CONCLUSION In these cases,the modified unilateral IOAT was an effective and safe surgical method for treating DVD with SOP.展开更多
BACKGROUND Heavy eye syndrome(HES)is an acquired strabismus typically seen in eyes with high myopia.We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial ...BACKGROUND Heavy eye syndrome(HES)is an acquired strabismus typically seen in eyes with high myopia.We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial rectus muscle and lateral rectus muscle resection procedures.CASE SUMMARY A 71-year-old woman presented with both eyes fixed in adduction and infraduction for 33 years.She had undergone three complicated strabismus surgeries to amputate the left medial rectus(MR)muscle with lateral rectus muscle recession,but no improvement in the esotropia appeared after each operation.She was diagnosed with HES and underwent a bilateral Yokoyama procedure and recession of the right MR muscle under general anesthesia.After surgery,her eyes were binocularly aligned for 6 mo.This case suggests that pertinacious esotropia combined with high myopia must be considered in HES.Orbital imaging and ultrasonography can demonstrate anatomical abnormality and mu-scle paths to confirm a definite diagnosis.CONCLUSION The Yokoyama procedure was effective in correcting HES.展开更多
基金Supported by The Natural Science Foundation of Shandong Province,No.ZR2018BH013The China Postdoctoral Science Foundation,No.2017M612214.
文摘BACKGROUND Inferior oblique anterior transposition(IOAT)has emerged as an effective surgery in the management of dissociated vertical deviation(DVD)combined with superior oblique palsy(SOP).Traditional IOAT usually provides satisfactory primary position alignment and simultaneously restricts the superior floating phenomenon.However,it also increases the risk of the anti-elevation syndrome and narrowing of the palpebral fissure in straight-ahead gaze,especially after the unilateral operation.CASE SUMMARY We report the outcomes of the modified unilateral IOAT in two patients with unilateral DVD combined with SOP.The anterior-nasal fibers of the inferior oblique muscle were attached at 9 mm posterior to the corneal limbus along the temporal board of the inferior rectus muscle,the other fibers were attached a further 5 mm temporal to the anterior-nasal fibers.Postoperatively,both hypertropia and floating were improved,and no obvious complications occurred.CONCLUSION In these cases,the modified unilateral IOAT was an effective and safe surgical method for treating DVD with SOP.
基金Supported by the Natural Science Foundation of Shandong Province,No.ZR2018BH013the China Postdoctoral Science Foundation,No.2017M612214.
文摘BACKGROUND Heavy eye syndrome(HES)is an acquired strabismus typically seen in eyes with high myopia.We report a classic case in which a patient was misdiagnosed with esotropia and underwent disinsertion of the medial rectus muscle and lateral rectus muscle resection procedures.CASE SUMMARY A 71-year-old woman presented with both eyes fixed in adduction and infraduction for 33 years.She had undergone three complicated strabismus surgeries to amputate the left medial rectus(MR)muscle with lateral rectus muscle recession,but no improvement in the esotropia appeared after each operation.She was diagnosed with HES and underwent a bilateral Yokoyama procedure and recession of the right MR muscle under general anesthesia.After surgery,her eyes were binocularly aligned for 6 mo.This case suggests that pertinacious esotropia combined with high myopia must be considered in HES.Orbital imaging and ultrasonography can demonstrate anatomical abnormality and mu-scle paths to confirm a definite diagnosis.CONCLUSION The Yokoyama procedure was effective in correcting HES.
