Document Detail


Dose-response relationship in inferior oblique muscle recession.
MedLine Citation:
PMID:  18253746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recession of the inferior oblique muscle is a widely applied operation in the treatment of strabismus sursoadductorius. In this retrospective study, the dose-response relationship of this procedure was determined in order to improve surgical outcomes. In particular, the effect of an additional anteroposition of the operated muscle was analysed, as well as differences between short and long term results. METHODS: This retrospective study included 37 patients. Inclusion criteria were unilateral strabismus sursoadductorius and normal retinal correspondence. Exclusion criteria comprised previous ocular muscle surgery and any ocular or orbital disease. Nineteen patients had received an additional anteroposition of the muscle. Patients were examined at a tangent screen pre-operatively and 1 day post-operatively (short-term effect). Sixteen patients underwent an additional examination 3 months post-operatively (long-term effect). Changes of vertical, torsional and horizontal deviations, measured in different positions of gaze, were related to the surgical dose in order to calculate the dose-response relationship by linear regression analysis. RESULTS: Surgery always reduced preoperative deviations. The short-term vertical dose-response without/with anteroposition was 0.6 degrees /0.5 degrees per mm in primary gaze and 1.2 degrees /1.1 degrees per mm in adduction. The short-term torsional dose-response without/with anteroposition was 0.8 degrees /0.5 degrees per mm in primary gaze. Three months later, the vertical effect had remained constant, whereas the torsional effect had decreased to 0.6 degrees /0.1 degrees per mm. Variance was high, e.g. the standard deviation of the short-term effect for the vertical deviation in adduction was 2.5 degrees . CONCLUSIONS: Despite the large variation of effects, a dose-response relationship could be established, facilitating surgical planning. Large vertical deviations with small excyclodeviation are an indication for additional anteropositioning. The torsional effect of inferior oblique muscle recessions can diminish over time.
Authors:
Miriam Metten; Heike Link; Flemming Staubach; Michael Bach; Wolf A Lagrèze
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Publication Detail:
Type:  Journal Article     Date:  2008-02-06
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie     Volume:  246     ISSN:  0721-832X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  593-8     Citation Subset:  IM    
Affiliation:
Universitäts-Augenklinik, Killianstr 5, 79106 Freiburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Female
Humans
Male
Middle Aged
Oculomotor Muscles / physiopathology,  surgery*
Ophthalmologic Surgical Procedures*
Retrospective Studies
Strabismus / physiopathology*,  surgery*
Vision, Binocular / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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