Adjustable Superior Oblique Tendon Spacer with Application of Nonabsorbable Suture for Treatment of Isolated Inferior Oblique Paresis

Fard, Masoud Aghsaei; Alipour, Ahmad; Anvari, Faramaz; Jafari, Alireza; Yazdian, Ziaeddin

doi:10.1177/112067211002000402

Cited by 2 publications

(2 citation statements)

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“…Hence, as strabismus surgery is usually performed under general anesthesia, intraoperative adjustments must be monitored using objective methods, namely, observation of the fundus torsion using an indirect ophthalmoscope (24,27). However, this presents some challenges.…”

Section: Discussionmentioning

confidence: 99%

“…For excyclotorsion commonly caused by SOP, the oblique muscles are usually targeted through direct manipulation of the superior oblique (SO) muscles with strengthening procedures, such as SO tucking or the Harada-Ito technique (21), whereas the inferior oblique (IO) muscle can be weakened by myotomy or myectomy (22). In rarer cases of incyclotorsion, the SO can be treated with weakening procedures, such as tenectomy (23) or tendon spacer (24), or, more rarely, the IO strengthened with tucking or advancement techniques (25).…”

Section: Introductionmentioning

confidence: 99%

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A simple marking system for accurate intraoperative monitoring and adjustment of cyclotorsion strabismus surgery

et al. 2023

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Ocular cyclotorsion is treatable only with surgery. The surgical procedure must be tailored individually to the specific etiologies causing the horizontal and vertical strabismus and its torsional components. An adjustable surgical approach is often used for postoperative or intraoperative adjustments. However, the methods currently used have some limitations. In this study, we propose a simple intraoperative marking system for all cyclotorsion correction surgery. The proposed marking system used three sets of surface markers: external horizontal markings, ocular horizontal markings, and surgical torsion markings, drawn in sequence. We retrospectively analyzed the surgical results using this novel marking system in this single-center, single-surgeon study. Fifteen patients with cyclotorsion who underwent treatment using the proposed marking system as an intraoperative aid between August 2019 and August 2021 were included. The medical charts were thoroughly reviewed, and the pre-and postoperative subjective and objective cyclotorsion were analyzed. Among the study subjects (10 males, 5 females; age range: 6–89 years), 13 had excyclotorsion and 2 incyclotorsion. Preoperative mean net subjective cyclotorsion measured by the double Maddox rod (DMR) test was 6.0° (standard deviation: 10.8°) and mean net disc-to-fovea angle (DFA) was 20.23° (13.21°). The postoperative net DMR and DFA were 0.2° (2.1°) and 14.09° (5.97°), respectively. The mean absolute net DMR and DFA being treated were 9.8° (4.8°) and 9.76° (4.61°). Overall, the proposed intraoperative marking system is a simple and quantitative method to assess, monitor, and adjust the torsional aspect for all strabismus surgeries.

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Section: Discussionmentioning

confidence: 99%