ABSTRACT
Full tendon width vertical transposition (Knapp procedure) of the horizontal recti is an established treatment for double elevator palsy (DEP) but the long-term stability of the surgical results have not been well studied. We undertook a retrospective study to determine the overall effectiveness of the Knapp procedure, the postoperative stability of alignment, and the influence of prior inferior rectus muscle recession (IRc) on the magnitude of correction. Nineteen patients with DEP underwent a Knapp procedure. Eight were corrected to within 5 delta of orthophoria, six were undercorrected, and five were overcorrected by at least 5 delta after a mean follow-up of 3 years (to last visit or to further surgical intervention). The average vertical correction was 37.5 delta in patients who underwent a prior IRc compared with 21.1 delta in patients with no prior IRc (p = < 0.0017). Over and undercorrections were more likely to occur in patients with prior IRc. Postoperative drift was towards increased effect in all patients. The seven patients with long-term (> 36 months) follow-up demonstrated an increased magnitude of correction (average = 12.6 delta) over an average follow-up of 76 months. The Knapp procedure had an increasing effect over time but the amount of vertical correction did not correlate with the size of the preoperative vertical deviation and was less predictable when a prior IRc had been performed.
Subject(s)
Oculomotor Muscles/surgery , Ophthalmology/methods , Ophthalmoplegia/surgery , Adolescent , Adult , Child , Child, Preschool , Humans , Infant , Retrospective Studies , Time FactorsSubject(s)
Laser Therapy , Light Coagulation , Retinopathy of Prematurity/surgery , Cryosurgery , Humans , Infant, Newborn , Laser Therapy/instrumentation , Laser Therapy/methods , Ophthalmoscopes , Postoperative Period , Retinopathy of Prematurity/complications , Retinopathy of Prematurity/pathology , Vitreous Hemorrhage/complicationsABSTRACT
We studied two patients who had infantile malignant osteopetrosis, severe visual loss, and diminished electroretinogram amplitudes with visible macular chorioretinal degenerative changes. The findings support the hypothesis that a subgroup of patients with infantile malignant osteopetrosis exists in whom the visual loss is caused by a primary retinal degeneration that may be associated with generalized central nervous system neuronal degeneration.
Subject(s)
Choroid Diseases/etiology , Osteopetrosis/complications , Retinal Degeneration/etiology , Choroid Diseases/pathology , Electroretinography , Eye/diagnostic imaging , Female , Humans , Infant , Male , Ophthalmoscopy , Optic Nerve/pathology , Osteopetrosis/physiopathology , Retinal Degeneration/pathology , Tomography, X-Ray ComputedABSTRACT
Automated static threshold perimetry was performed in both eyes of 10 normal and 12 ocular hypertensive subjects treated with a topical beta-blocker, before and after Goldmann applanation tonometry of their right eyes. Both objective statistical comparison and subjective evaluation of the resultant visual fields showed no detrimental effect on visual field test results after applanation tonometry.
Subject(s)
Ocular Hypertension/physiopathology , Tonometry, Ocular/methods , Visual Field Tests/methods , Visual Fields , Adrenergic beta-Antagonists/therapeutic use , Humans , Intraocular Pressure , Ocular Hypertension/diagnosisABSTRACT
The time-dependent increase in apparent facility of outflow (washout effect) that occurs with prolonged perfusion of the eye has imposed limitations on the study of aqueous humor dynamics. The washout effect in postmortem in situ rabbit eyes, undergoing constant pressure perfusion with a saline perfusate, can be attenuated dramatically by adding to the perfusate the serine protease inhibitor and antifibrinolytic agent epsilon-aminocaproic acid (EACA) at a concentration of 3.8 X 10(-3) molar. Washout curves from 13 pairs of rabbit eyes, plotted as outflow facility versus time, were fitted by linear regression, and their washout slopes calculated. The washout slope of all of the 13 eyes perfused with normal saline + EACA was lower in magnitude (less washout) than the paired control eye in the same animal, perfused with a control perfusate of normal saline + leucine. Wilcoxon signed rank test yielded P less than 0.001. This suggests that a significant component of the washout effect may be mediated by fibrinolytic activity, or by some EACA sensitive component of the aqueous drainage pathway, and that addition of EACA to a saline perfusate may be useful for blunting the washout effect in prolonged perfusion studies.
