ABSTRACT
PURPOSE: The aim of the study is to evaluate results of surgical treatment of strabismus and diplopia in Graves-Basedow ophthalmopathy. MATERIAL AND METHODS: The surgical procedure was performed in 40 patients with horizontal strabismus, horizontal strabismus with vertical deviation or isolated vertical strabismus. There were performed 86 surgical procedures on the eye muscles (in 20 cases adjustable sutures were used). RESULTS: Recovery or recovery without binocular single vision was observed in 27 cases (67.5%) and improvement in 11 cases (27.5%). CONCLUSIONS: The necessary conditions of surgical treatment are stabile euthyreoid state, the stabilization of the angle of strabismus and diplopia. The best results of operation are in the prefibrosis period of the muscle directly. The surgical procedures of weakening the function of muscles and adjustable sutures are recommended. The operations of several stages and atraumatic should be performed.
Subject(s)
Diplopia/surgery , Graves Disease , Strabismus/surgery , Adult , Diplopia/complications , Female , Humans , Male , Middle Aged , Strabismus/complications , Treatment OutcomeABSTRACT
Between 1979-1994 120 patients with acquired paralysis of cranial nerves of ocular muscles were treated: 33 cases with paralysis of oculomotor nerve, 43 cases with paralysis of trochlear nerve, 44 cases with paralysis of abducens nerve. The majority of our patients were males (84-70.0%) aged 21-40 years (65-54.2%). The paralysis was most frequently caused by traffic accidents (45 cases--37.5%) and assaults (26 cases--21.7%). The most common symptom of paralysis was diplopia (109 patients--90.8%). Only 12 persons (10.0%) were admitted during the first month of paralysis and visual disorders caused by it. In our group 18 patients (15.0%) were treated conservatively. Sixteen patients (13.3%) were given injections of botulin toxin A into the eye muscles. Surgical treatment, usually of several ocular muscles, was performed in 83 cases (67.5%) when diplopia was not reduced after 6-12 months. The method of surgery and results are presented.
Subject(s)
Cranial Nerve Diseases/therapy , Paralysis/therapy , Abducens Nerve Injury , Adolescent , Adult , Aged , Botulinum Toxins/therapeutic use , Child , Child, Preschool , Cranial Nerve Diseases/etiology , Diplopia/etiology , Female , Humans , Male , Middle Aged , Neoplasms/complications , Oculomotor Muscles/innervation , Oculomotor Muscles/surgery , Oculomotor Nerve Diseases/etiology , Oculomotor Nerve Diseases/therapy , Oculomotor Nerve Injuries , Paralysis/etiology , Trochlear Nerve Injuries , Vascular Diseases/complicationsSubject(s)
Botulinum Toxins/administration & dosage , Oculomotor Muscles , Strabismus/therapy , Adolescent , Adult , Female , Humans , Injections, Intramuscular , Male , Middle AgedSubject(s)
Oculomotor Muscles/surgery , Ophthalmoplegia/surgery , Strabismus/surgery , Sutures , Adult , Eye Movements , Female , Follow-Up Studies , Humans , Male , Middle Aged , Oculomotor Muscles/physiopathology , Suture TechniquesABSTRACT
In 21 patients with traumatic diplopia, oculomyodynamometry (OMD) was used to examine the force of the extrinsic ocular muscles. In nine patients with blow-out fracture of the orbit, the greatest impairment in the active force and function of the incarcerated muscle was found in linear fractures. In 12 cases of traumatic paresis of the cranial nerves, OMD enabled the degree of paresis of particular extraocular muscles to be assessed, was helpful in establishing a correct diagnosis as well as prognosis for the restoration of function of the affected muscles, and provided data useful in planning the operative procedure.
