Document Detail


Torsional diplopia after orbital decompression and strabismus surgery.
MedLine Citation:
PMID:  19882516     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate diplopia after orbital decompression in patients with thyroid-related orbitopathy. METHODS: We retrospectively analyzed medical records of 45 consecutive patients who had undergone orbital decompression surgery (DS) and a subgroup of 10/45 patients who underwent disinsertion of the inferior oblique (IO) muscle during DS. Diplopia was assessed before DS and 1 and 3 months after DS. Residual strabismus defects were treated surgically approximately 3 months after DS with follow-up visits 1 week, 3 months, and 6 months postoperatively. Patients with horizontal or vertical diplopia were evaluated using the alternate prism-and-cover test and torsional diplopia (TD) using a double Maddox rod test to quantitate their strabismus. RESULTS: Strabismus surgery was effective in treating the horizontal and vertical diplopia (13/40 cases with residual deviations required prism glasses), but did not resolve the TD. None of the patients with IO disinsertion during DS complained of TD before strabismus surgery. However, after strabismus surgery, TD occurred in all 10 patients with IO disinsertion vs 8/30 patients without IO disinsertion (p<0.001, Fisher exact test). Overall, TD was induced in 18/45 (40%) of the DS cohort. CONCLUSIONS: Patients with IO disinsertion during DS may be at increased risk of developing TD postoperatively. We recommend sparing or reattaching the IO muscle during DS when possible to reduce the risk of developing untreatable TD.
Authors:
Massimiliano Serafino; Paolo Fogagnolo; Rupal H Trivedi; Richard A Saunders; Paolo Nucci
Related Documents :
17163476 - Monopolar radiofrequency treatment of human eyelids: a prospective, multicenter, effica...
18784446 - Consecutive esodeviation after exotropia surgery in patients older than 15 years: compa...
19863326 - Outcomes of type ii thyroplasty for adductor spasmodic dysphonia: analysis of revision ...
21117546 - Cholera in haiti.
11740176 - Selective denervation and resection of cervical muscles in the treatment of spasmodic t...
17355626 - Factors influencing change of preoperative treatment intent in a gastrointestinal cance...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  20     ISSN:  1120-6721     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-03-11     Completed Date:  2010-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  437-41     Citation Subset:  IM    
Affiliation:
Paediatric Ophthalmology and Strabismus Unit, Department of Surgery, San Paolo Hospital, University of Milano, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Decompression, Surgical / adverse effects*
Diplopia / diagnosis,  etiology*
Female
Follow-Up Studies
Graves Ophthalmopathy / surgery*
Humans
Male
Middle Aged
Oculomotor Muscles / surgery*
Ophthalmologic Surgical Procedures / adverse effects*,  methods
Postoperative Complications
Retrospective Studies
Strabismus / surgery*
Grant Support
ID/Acronym/Agency:
EY-14793/EY/NEI NIH HHS

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


Previous Document:  Natural killer/T-cell lymphoma of nasal type with intraocular involvement: case report.
Next Document:  Which choroidal melanoma should be treated with primary transpupillary thermotherapy? Our experience...