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Purpose: This study aimed to investigate the effect of virtual reality (VR) technology in children after surgery for concomitant strabismus. Methods: A total of 200 children with concomitant exotropia or concomitant esotropia were randomly divided into a training group and a control group according to the single even number random method (100 cases in each group). Patients in the training group received VR intervention training within 1 week after surgery. Patients in the control group did not receive any training. Results: Six months after the surgery, the orthophoria (the far or near strabismus degree was ?8?) rate was significantly higher in the training group than in the control group (P = 0.001), while the eye position regression rate (compared to the strabismus degree within 1 week after the surgery, the amount of regression >10?) was significantly lower in the training group than in the control group (P = 0.001). Six months after the surgery, the number of children with simultaneous vision and remote stereovision was significantly higher in the training group than in the control group (P = 0.017 and 0.002, respectively). The differences in the number of patients with peripheral stereopsis, macular stereopsis, and stereopsis in macular fovea centralis at 1, 3, and 6 months after the surgery between the training and the control groups were not statistically significant (P = 0.916, 0.274, and 0.302, respectively). Conclusion: The intervention of VR technology after strabismus correction effectively improved children’s visual function and maintained their eye position
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AIM: To investigate the role of visual perception training on the recovery of visual function at all levels and the improvement of perceptual eye position in children with intermittent exotropia(IXT).METHODS: Prospective clinical study. A total of 74 patients with IXT who received corrective surgery for strabismus in the Ophthalmology Department of the First People's Hospital of Lanzhou City from January to June 2022 were collected and followed up for 3mo. The patients were randomly divided into 2 groups at 1d after surgery: 35 patients in the training group received binocular visual perception training, and 39 patients in the control group did not receive visual training. The changes of visual function and perceived eye position at all levels were observed at 1d and 3mo after operation.RESULTS: There were 24 patients(69%)with simultaneous perception in the training group at 1d after surgery and 34 patients(97%)with recovered visual function at 3mo after surgery, which was significantly higher than 1d after surgery(P=0.002). Furthermore, there were 22 cases(56%)of fusion function in the control group at 3mo after surgery, 13 cases(33%)of far stereopsis, 20 cases(51%)of dynamic stereopsis and 17 cases(44%)of static fine stereopsis. In the training group, there were 31 cases(89%)of fusion function, 25 cases(71%)of far stereopsis, 30 cases(86%)of dynamic stereopsis and 27 cases(77%)of static fine stereopsis, which were significantly higher than those in the control group(all P<0.05). The degree of perceived eye displacement in the training group decreased more significantly than that in the control group(all P<0.05).CONCLUSION: Postoperative visual perceptual training in children with IXT can promote recovery of visual function at all levels, improve perceptual eye position and enhance the control of eye position at the perceptual level of the brain.
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@#AIM: To explore the influence factors of the mid-long-term postoperative eye position of patients with intermittent exotropia(IXT).<p>METHODS: Retrospective analysis was performed on the clinical data of 78 patients with intermittent exotropia admitted to the ophthalmology department of our hospital during 2017-01/2018-08. Data of patients with strabismus type,operation age, preoperative binocular vision function and the eye position of preoperative and postoperative day one were collected, to explore the influence factors of the mid-long-term postoperative eye position.<p>RESULTS: The result display that 47 cases(60%)had positive eye position in the mid-long-term after operation. There were 43 cases of insufficient collection type, 18 cases(42%)cured in eye position. The operation was successful in 26 of the 31 cases(84%)of basic type; 3 of 4(75%)divergence excess type were successful after operation. The results of univariate analysis showed that the difference of strabismus type and preoperative eye position between the two groups was statistically significant(<i>P</i><0.05). Multivariate logistic regression analysis showed that type of strabismus(<i>OR</i>: 5.769, 95% <i>CI</i>: 1.790-18.595), was independent influencing factors of the eyes position in the mid-long-term after operation(<i>P</i><0.05).<p>CONCLUSION:The strabismus type was independent predictors of the eyes position in the mid-long-term after operation, which should be paid more attention in clinical practice.
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@#AIM: To explore whether low myopia would affect cerebral visual functions by comparing perceptual eye position(PEP), fixation stability and stereoacuity tests between low myopic and normal adolescents. <p>METHODS: Totally 120 adolescents matched in age and gender participated in our study. Subjects were divided into three groups according to their refractive states. The cerebral visual functions tested in our study included perceptual eye position(PEP), fixation stability and stereoacuity. Stereoacuity tests involved in our study could be categorized into two parts. The first part was classical stereo tests including Titmus and synoptophore stereo test. The second part was 3D random-dot test for zero-order stereoacuity(hereinafter as zero-order test)at different viewing distances(0.8 m and 1.5 m).<p>RESULTS:1)PEP: the deviation of horizontal PEP was significantly larger in non-anisometropia when compared to control group. Both horizontal and vertical PEP bias pixels were significantly larger in anisometropia group. 2)χ2 test showed that both non-anisometropia group and anisometropia group had more trouble in holding their fixation stable. Moreover, anisometropia group had more abnormal results than other two groups. And in zero-order test at 1.5 m, both non-anisometropia and anisometropia had more abnormal results in stereoacuity than control group. The correlation between fixation stability and near stereoacuity(Titmus and zero-order stereoacuity at 0.8 m)was weak and positive.<p>CONCLUSION:Low myopic adolescents still have certain defects in cerebral visual functions; Examinations used in our study were useful in assessing cerebral visual functions. They could provide better follow-up evaluation and solid ground for further specific treatments in treating defects of cerebral visual functions. So far, local retinal environment has been the focus on the development in myopia. Our results suggested that researchers might pay more attention on visual cortex in studying the mechanisms of myopia in the near future.
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@#AIM: To evaluate the effects of visual perceptual learning on visual representation and binocular vision function of children with amblyopia. <p>METHODS: A total of 94 cases(94 eyes)children with amblyopia admitted to the ophthalmology clinic of our hospital from January 2014 to December 2015 were selected for the study and were grouped according to the degrees of amblyopia, and they were given visual perceptual learning for 3mo. The clinical efficacy and perceptual level of eye position and poor visual acuity before and after treatment were compared among groups, and Pearson correlation coefficient was used to analyze the relationship between difference of poor visual acuity and difference of perceptual eye position before and after treatment in children with amblyopia. <p>RESULTS: The total clinical effective rate of children with mild amblyopia was higher than that of children with moderate or severe amblyopia(<i>P</i><0.05), and there was no significant difference in the total clinical effective rate between children with moderate amblyopia and children with severe amblyopia(<i>P</i>>0.05). The perception level of eye position after treatment of children with amblyopia was significantly lower than that before treatment(<i>P</i><0.05). The perception level of eye position after treatment in children with mild, moderate or severe amblyopia was significantly decreased(<i>P</i><0.05), and the improvement of perception level of eye position in children with mild or moderate amblyopia was more significant than that in children with severe amblyopia(<i>P</i><0.05). The poor visual acuity of children with amblyopia after treatment was significantly improved compared with that before treatment(<i>P</i><0.05). The poor visual acuity after treatment in children with mild, moderate or severe amblyopia was significantly improvement(<i>P</i><0.05), and the improvement of poor visual acuity in children with mild or moderate amblyopia was more significant than that in children with severe amblyopia(<i>P</i><0.05). The difference of poor visual acuity was positively correlated with difference of perceptual eye position before and after treatment among children with amblyopia(<i>r</i>=0.371,<i> P</i><0.05). <p>CONCLUSION: Visual perceptual learning can effectively improve the visual representation and binocular vision function of children with amblyopia, and it is suitable for the clinical treatment of children with amblyopia.
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·Eye position control is essential for the management of intermittent exotropia, which it may be a caritia for the surgery intervention, as well as a indicator for the severity of the deviation. Thus, the quantitaties of intermittent exotropia eye position control ability is crucial. This article aims to review the assessment method of the eye position control of intermittent exotropia, so as to clearly a need for a well planned, prospective clinical intervention.
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PURPOSE: To assess the relationship between eye position and anesthesia depth using the bispectral index (BIS) value, a parameter derived from electroencephalography data. METHODS: We investigated the relationship between BIS value and eye position in 32 children who underwent surgery for epiblepharon under general anesthesia. BIS values were recorded continuously throughout the procedure (from induction to awakening). Eye positions were video-recorded and analyzed after surgery. The vertical position of each eye was scored according to its height in relation to the medial canthus. An eye position in which the upper eyelid covered one-third of the cornea was defined as a significant ocular elevation. RESULTS: The BIS value correlated inversely with the end-tidal concentration of each anesthetic agent, whereas it correlated positively with the eye elevation score (eye position = 0.014 × BIS + 0.699, p = 0.011). The mean eye position score was significantly greater in patients whose BIS values were over 65. Eleven patients (34.4%) had significant ocular elevation; their mean concurrent BIS value was 61.6. Two of these patients had elevation during surgery and 9 had elevation during emergence from anesthesia. CONCLUSIONS: We found that high BIS values were correlated with low levels of anesthetic concentration and high eye position, suggesting that BIS monitoring may be useful for predicting eye position during anesthesia. Particular attention must be given to eye position during ophthalmic surgery. Anesthesia depth can be maintained by assuring that the BIS value remains below 65.
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Niño , Humanos , Anestesia , Anestesia General , Córnea , Electroencefalografía , Electrofisiología , Párpados , Aparato LagrimalRESUMEN
Objective To investigate the influencing factors of stereopsis and ocular position changes before and after intermittent exotropia sur-gery. Methods A total of 70 cases diagnosed with intermittent exotropia(squint angle>15△and0.05). There was no statistical difference in the recovery rate of stereopsis and the orthostatic rate of eyes between the groups of 45△and more than 45△. Conclusion Intermittent exotropia surgery can effectively improve the stereopsis and eye po-sition,and the outcomes of surgery are related to the age of surgery. The recovery rate of stereopsis is higher in the patients with intermittent exotro-pia during the visual development period. Regardless of the size of the angle of squint ,early surgery is benefit to the recovery of stereopsis.
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@#AIM: To study eye position control ability in patients with different types of intermittent strabismus. <p>METHODS: Totally 146 patients with intermittent strabismus treated in our hospital from September 2013 to April 2015 were enrolled in the study. The patients were divided into three groups according to the different types of the patients with intermittent strabismus. Fifty-five patients who had been separated from the strong type were used as part of the strong group,the basic type of 48 cases as the basic group,44 cases of collection insufficiency patients were set up as collection insufficiency group. Visual function and postoperative eye correction of the three groups were analyzed. <p>RESULTS: There were no differences in visual function among the three groups before operation, and the visual function of the three groups were improved after operation, and there was no difference among the three groups(<i>P</i>>0.05).The positive rates were 83.3%,81.2% and 54.6% of the strong group, basic group and collection insufficiency group respectively. There was no difference between the strong group and basic group,(<i>P</i>>0.05).There were significant differences between the strong group, basic group with collection insufficiency group(<i>P</i><0.05).<p>CONCLUSION: Operations for intermittent external strabismus is different according to different types. The prognosis of the strong group and basic group is good and the prognosis of collection insufficiency group is poor.
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Objective To study the effect of binocular vision function training for fusion in the eye position and three levels of eye function in adult patients after concomitant strabismus surgery. Methods 56 cases with postoperative concomitant strabismus were randomly divided into training group and control group . In the training group, patients were trained with software to enhance the fusion. After training for 7, 30, 180 and 365 days, the eye position, the fusion and the stereoesthesia were observed and analyzed. Results After training for 365 days, the deteriorative ratio in the training group is 3%, which is significantly lower than control group (23%)(P<0.05). The correction ratio in eye position is 20%, which is significantly higher than control group (4%)(P<0.05). The recovery ratio in binocular vision function is 53%, which is significantly higher than control group (15%)(P<0.05). The recovery ratio in stereaeuity is 46%, which is significantly higher than control group (11%)(P<0.05). Conclusions Fusion training can enhance the recovery of fusion and stereaeuity, decrease the deteriorative ratio, and correct the eye position after surgery in concomitant strabismus patients.
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Objective To investigate the clinical effects of preoperative eye position training on femtosecond laser-assisted laser in situ keratomileusis(FL-LASIK)? Methods One hundred and sixty-eight myopia patients(328 eyes)scheduled for selective FL-LASIK were randomly divided into the experiment group of 85 cases(166 eyes)and the control group of 83 cases(162 eyes)?The patients in the control group were given the routine preoperative education and the patients in the experiment group received the preoperative intervention of eye position besides routine preoperative education? The two groups were compared in terms of intraoperative changes of eye position,corneal topography and the postoperative visual acuity? Results The frequency of eye position adjustment and machine stopping in the experiment group was significantly smaller than that of the control group(P 0?05)? Conclusion Preoperative training of eye position may maintain ideal eye position and reduce the frequency of downtime due to eye position adjustment during FL-LASIK,which may ensure the successful completion of FL-LASIK?
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PURPOSE: We studied change of eye position according to surgical amount with strabismus surgery under general anesthesia. METHODS: The 101 horizontal strabismus patients were classified into 5 groups and analyzed according to strabismus type, surgical method, and surgical amount. Group I had less than 7 mm recession in exotropia;, group II, was more than 7 mm recession in exotropia;, group III, was recession and resection in exotropia;, group IV, was less than 5.5 mm recession in esotropia;, group V, was more than 5.5 mm recession in esotropia. We measured eye position, corneal reflex and medial limbus by photographic measurement taken at a distance of 40 cm form the patient in the supine position. RESULTS: The mean amount of convergence in exotropia group I was 8.93+/-2.21PD, exotropia group II was 9.64+/-3.50PD, exotropia group III was 10.77+/-4.11PD. The mean amount of divergence of esotropia group IV was 6.62+/-2.10PD, esotropia group V was 7.88+/-2.90PD. The exotropia and esotropia groups were not statistically different from each other (P>0.05). The correlation coefficient according to surgical amount was 0.18 in exotropia groups, 0.01 in esotropia groups. CONCLUSIONS: The change of eye position according to surgical amount showed a weak positive correlation in exotropia groups, but showed no correlation in esotropia groups. Postoperative mean change in eye position was distributed from 9.26PD to 10.90PD in the exotropia group, from 6.10PD to 7.83PD in the esotropia group with 95% confidence interval and was difficult to expect overcorrection and undercorrection after awaking from anesthesia.
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Humanos , Anestesia , Anestesia General , Esotropía , Exotropía , Reflejo , Estrabismo , Posición SupinaRESUMEN
To investigate the short-term vestibular responses in the pilots, the 4 successive velocity step tests were done on the 25 pilots, who are in active service in ROKAF (Republic of Korea Air Force), and the obtained results were compared with those of the non-pilots. As the repeated rotations might alter the vestibulo-ocular reflex (VOR), sinusoidal harmonic acceleration (SHA) test at a frequency of 0.16 Hz were also given before and after the 4 successive velocity step tests to investigate the changes of gain and phase of VOR. In the 25 pilots (mean age 31 year), the mean values of the slow cumulative eye position (SCEP), the time integral of eye velocity during nystagmus and time constants were gradually reduced with 4 successive trials. These values were significantly greater than those obtained in the 25 non-pilots. The gain of vestibulo-ocular reflex (VOR) induced by SHA test at a frequency of 0.16 Hz decreased from 0.64+/-0.04 to 0.58+/-0.03 in the pilots, while the VOR gain increased from 0.59+/-0.03 to 0.78+/-0.06 in the non-pilots. However, this result did not indicate that the pilots' gains of VOR were out of normal range. In another SHA tests in which the 30 pilots participated, the gains, phases and the symmetries of VOR lied in the very normal range in every test frequencies (0.01, 0.02, 0.04, 0.08, 0.16, 0.32 Hz). From the above results, it might be suggested that the vestibular responses of the pilots are different with those of the non-pilots.
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Aceleración , Prueba de Esfuerzo , Corea (Geográfico) , Valores de Referencia , Reflejo VestibuloocularRESUMEN
PURPOSE: Eye position of orthophoric patients in awakened state was evaluated under general anesthesia to determine the anatomical position of rest. METHODS: About 25 to 30 minutes after induction of general anesthesia, we measured the amount of eye deviation at 30 cm and 1 m by Krimsky method in 143 orthophoric patients who had no neurological disorder, limitation of eye movement or previous history of extraocular muscle surgery. RESULTS: Of the 143 patients, 54(37.8%) were male and 89(62.2%) were female. Under general anesthesia, eye position checked at 30 cm was 20.9+/-7.8D divergent and eye position at 1 m was 20.6+/-7.7D divergent. Checked at 30 cm, male patients demonstrated 20.1+/-6.6D of divergence and female patients, 21.3+/-8.4D of divergence. Checked at 1 m, eye position was 20.0+/-6.5D divergent in male and 21.0+/-8.4D divergent in female. The differences between sexes and between ages were not significant(p>0.05). CONCLUSIONS: The orthophoric patients in awakened state demonstrated 20.9+/-7.8D of divergence at 30 cm, 20.6+/-7.7D of divergence at 1 m under general anesthesia. And these results show the anatomical position of rest in orthophoric subjects.