[Binocular vision and vertical strabismus].

BACKGROUND/AIM: Elevation in adduction is the most common pattern of vertical strabismus, and it is mostly treated with surgery. The results of weaking of inferior oblique muscle are very changeable. The aim of this study was to evaluate binocular vision using sensory tests before and one and six months after the surgery. METHODS: A total of 79 children were divided in two groups: the first, with inferior oblique muscle of overaction (n = 52), and the second with dissociated vertical deviation (DVD), and primary inferior oblique muscle overaction (n = 27). We tested them by polaroid mirror test (PMT), Worth test at distance and near, fusion amplitudes on sinoptofore, Lang I stereo test and Wirt-Titmus stereo test. We examined our patients before and two times after the surgery for vertical strabismus. RESULT: Foveal suppression in the group I was found in 60.5% of the patients before, and in 56.4% after the surgery. In group II Foveal suppression was detected in 64.7% of the patients before, but in 55.6% 6 months after the surgery with PMT. Worth test revealed suppression in 23.5% of the patients before, and in 40.7% after the vertical muscle surgery. Parafoveal fussion persisted in about 1/3 of the patients before the surgery, and their amplitudes were a little largen after the surgery in the group I patients. Lang I stereo test was negative in 53.9% before and 51.9% after the surgery in the group I, and in 48.2% of the patients before and after the surgery in the group II patients. Wirt-Titmus stereo test was negative in 74.5% of the patients before and in 72.9% after the surgery in the group I, but in the group II it was negative in 70.8% before and in 68.0% of the patients 6 months after the surgery. CONCLUSION: Binocular responses were found after surgury in 65.7% of the patients the group I and in 55.6% patients the group II. There was no significant difference between these two groups, but binocular responses were more often in the patients of the group I.

Persistent strabismus after cataract extraction.

BACKGROUND: Transient ocular misalignment as a complication of parabulbar and peribulbar anesthesia has already been reported in the literature. The aim of our study was to present a case of irreversible iatrogenic vertical strabismus after cataract surgery, which had to be operated on. METHODS: Clinical and orthoptic evaluation of a female patient with vertical diplopia after phacoemulsification cataract surgery. RESULTS: One week after the uneventful surgery, a 68-year-old patient complained of a sudden vertical deviation in the operated eye. The patient had not had a history of previous motility disorders. On examination, the patient showed hypertropia in the left eye of 15-20 degrees in primary position. Three and 6 months postoperatively, there was no a spontaneous improvement, while the persistent vertical deviation was 40 prism dioptres. Strabismus surgery was required 1 year after the cataract surgery. CONCLUSION: Diplopia is a complication of peribulbar anesthesia which could be persistent. The superior and inferior rectus muscle are especially vulnerable. Its occurrence may be technique--related and the incidence increases when hyaluronidase is not available.

[Correction of presbyopia in pseudophakic patients under 60 years of age]. / Prezbiopna korekcija kod pseudofaka mladjih od sezdeset godina.

Objective of the study was to show the mean values of correction for near vision and to discuss the presbyopic correction in pseudophakic patients. Setting was the Eye department where authors work. Inclusion criteria for 55 patients were native or corrected distant vision of 0.8-1.0 on Snellen's chart; 0,6 on Jagger's chart for near vision; round pupil and good position of the implant. Biometry of the anterior chamber depth with Alcon biophysics during distant and near vision was performed in our study. "Hi square" test was carried out and it was concluded that patients younger than 59 years (41 eyes) had median correction of +2.0 dsph, while patients older than 60 years (36 eyes) had correction of +3.0 dsph, but it was not statistically significant. There was no statistically significant difference of the correction between pseudophakic (41) and phakic (19) eyes in patients younger than 59 years. The anterior movement of the IOL was 0.18 mm in the younger group and 0.15 mm in the older group. With good IOL movement and new materials which could have changeable refractive power, the problem of pseudophakic correction for near vision might be solved.