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2.
J Fr Ophtalmol ; 38(2): 118-25, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25596774

ABSTRACT

PURPOSE: During the surgical correction of dysthyroid diplopia, the risk of ischemia by transection of the anterior ciliary arteries is well-known. In order to avoid this, we modified the classical surgical technique: (1) through the preservation of the vascular pedicles during muscle recession and (2) if necessary, through a plication (instead of a resection) of the ipsilateral antagonist muscle. The objective to be achieved is thus the resolution of the diplopia without ischemic complications. SUBJECTS AND METHODS: We report a prospective series of 10 patients with dysthyroid ophthalmopathy, causing strabismic diplopia, all operated on by the same surgeon (BR) after at least 12 months of euthyroidism. Data collection included: history of previous decompressive surgery, surgical procedure, and oculomotor status before and after surgery. RESULTS: Ten patients (8 females), aged 51 to 74 years (mean age, 58.00 ± 7.62 years), were collected between 2008 and 2012. All patients had one or more vascular risk factors (diabetes, smoking, obesity, high blood pressure). With a follow-up from 16 to 67 months (mean ± SD 27.7 months ± 14.87), surgical outcomes were excellent: diplopia was cured in all cases, with recovery of stereoscopic vision. We had no operative or postoperative complications. CONCLUSIONS: The technique of preservation of the anterior ciliary vascularization, which is particularly justified for these fragile patients, is compatible with moderate muscle recessions. For larger deviations, in which a larger recession might increase the proptosis, it is possible to add a plication of the ipsilateral antagonist. This surgical technique made possible the suppression of the diplopia in all cases.


Subject(s)
Ciliary Arteries/surgery , Diplopia/surgery , Graves Ophthalmopathy/surgery , Organ Sparing Treatments/methods , Aged , Diplopia/etiology , Female , Graves Ophthalmopathy/complications , Humans , Ischemia/prevention & control , Male , Middle Aged , Postoperative Complications/prevention & control , Retrospective Studies
3.
J Fr Ophtalmol ; 33(4): 263.e1-3, 2010 Apr.
Article in French | MEDLINE | ID: mdl-20347181

ABSTRACT

Cavernous hemangioma is the most common primary vascular neoplasm. It typically occurs in middle-aged women, causing a progressive painless proptosis as the principal symptom. It exceptionally compresses the optic nerve. We report the case of a cavernous hemangioma revealed by optic neuropathy in a 33-year-old female.


Subject(s)
Hemangioma, Cavernous/diagnosis , Nerve Compression Syndromes/diagnosis , Optic Nerve Diseases/diagnosis , Orbital Neoplasms/diagnosis , Adult , Diagnosis, Differential , Exophthalmos/diagnosis , Female , Humans , Magnetic Resonance Imaging , Scotoma/diagnosis
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