ABSTRACT
The use of topical anesthesia for strabismus surgery can be useful in selected, cooperative patients. This technique is always performed on an ambulatory basis, and the surgical time rarely exceeded 30 minutes. One of the major advantages of this type of procedure is the ability to adjust the sutures during the operation. The presence of diplopia is a major indication for topical anesthesia. The use of Gracis grids has proved extremely useful for assessing the dynamic evolution of the diplopia over the various visual fields during the operation. This allows the surgeon to better control his correction, with horizontal, vertical, or torsional diplopia. Finally, this study shows that a precise clinical examination allows excellent results while limiting surgery to a single muscle (in 12 of the 14 cases).
Subject(s)
Anesthesia, Local , Oculomotor Muscles/surgery , Strabismus/surgery , Administration, Topical , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Suture TechniquesABSTRACT
This study compared the sensory status of 23 patients (19 children and 4 adults) before and after treatment with total hypermetropic correction. We have shown that binocular improvement can be obtained in every category of strabismological pathology, including exotropia, with the exception of early onset micro-strabismus. Three cases of late onset micro-strabismus (one divergent and two convergent) where total sensory cure was obtained are also described. We confirm the slow clinical progression of hypermetropia in the strabismic patient provided with total optical correction. The two examples reported, as well as our cursory review of recent literature, provide justification for the early, systematic prescription of total optical correction for strongly hypermetropic children (> 4 D).
Subject(s)
Hyperopia/physiopathology , Hyperopia/therapy , Strabismus/physiopathology , Adolescent , Adult , Child , Child, Preschool , Eyeglasses , Humans , Infant , Visual AcuityABSTRACT
This paper gives an original method to treat "intermittent exotropia" with normal binocular vision. 25 consecutive cases of exotropia have been followed, 17 cases near horizontal prism and 3 oblique prism (in association with a congenital fourth nerve paralysis). 4 patients near glasses without prism and only one was treated surgically. The results are promising and this method completes well orthoptic reeducation.
