Evaluation and Management of V pattern Strabismus in Craniosynostosis

Elhusseiny, Abdelrahman M.; Huynh, Elisah; Dagi, Linda R.

doi:10.1080/2576117x.2019.1693822

Cited by 8 publications

(2 citation statements)

References 47 publications

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“…Taking these complex issues into account will be important for optimizing their visual outcomes. Management of patients with Apert syndrome, as reviewed by Elhusseiny et al, 66 is known to be challenging, and a variety of approaches have been recommended based on consideration of muscle tone, excyclorotation of the EOMs, and imaging of the orbit prior to surgery. 66 These studies also suggest that a pharmacological approach, using molecules that alter the function of the FGF signaling pathways perhaps, may have an effect in this group of patients and deserves further study.…”

Section: Discussionmentioning

confidence: 99%

Morphological Differences in the Inferior Oblique Muscles from Subjects with Over-elevation in Adduction

Rudell

Felius

McLoon

2020

Invest. Ophthalmol. Vis. Sci.

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We examined inferior oblique muscles from subjects with over-elevation in adduction for characteristics that might shed light on the potential mechanisms for their abnormal eye position. METHODS. The inferior oblique muscles were obtained at the time of surgery in subjects diagnosed with either primary inferior oblique overaction or Apert syndrome. The muscles were frozen and processed for morphometric analysis of myofiber size, central nucleation, myosin heavy chain (MyHC) isoform expression, nerve density, and numbers of neuromuscular junctions per muscle section. RESULTS. The inferior oblique muscles from subjects with Apert Syndrome were smaller, and had a much more heterogeneous profile relative to myofiber cross-sectional area compared to controls. Increased central nucleation in the Apert syndrome muscles suggested ongoing myofiber regeneration or reinnervation over time. Complex changes were seen in the MyHC isoform patterns that would predict slower and more sustained contractions than in the control muscles. Nerve fiber densities were significantly increased compared to controls for the muscles with primary inferior oblique overaction and Apert syndrome that had no prior surgery. The muscles from Apert syndrome subjects as well as those with primary inferior oblique overaction with no prior surgery had significantly elevated numbers of neuromuscular junctions relative to the whole muscle area. CONCLUSIONS. The muscles from both sets of subjects were significantly different from control muscles in a number of properties examined. These data support the view that despite similar manifestations of eye misalignment, the potential mechanism behind the strabismus in these subjects is significantly different.

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Section: Discussionmentioning

confidence: 99%

Morphological Differences in the Inferior Oblique Muscles from Subjects with Over-elevation in Adduction

Rudell

Felius

McLoon

2020

Invest. Ophthalmol. Vis. Sci.

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“…Strabismus refers to the inability of both the eyes to look at the target at the same time, which is an extraocular muscle disease and can be divided into two categories: concomitant strabismus and paralytic strabismus [ 1 , 2 ]. Among them, the main clinical features of concomitant strabismus are that there is no eye movement disorder, and the strabismus degree in the first eye position and the second eye position is equal.…”

Section: Introductionmentioning

confidence: 99%

Observation on the Curative Effect of Microsurgery in 154 Children with Strabismus and Analysis of Its Influencing Factors

Zhao

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Strabismus is a common ophthalmic disease in the process of child body development, in which the two eyes cannot gaze at the target at the same time, and the incidence of this disease of children is higher. In children with esotropia, exotropia, and up and down strabismus and other typical symptoms, the cause is genetic, innerve, and refractive and regulated, and not receiving timely treatment may lead to stereo vision and diplopia and other phenomena, affecting their learning and life. Surgical treatment is the main treatment for strabismus at present. Traditional orthodontic surgery is performed by doctors under the naked eye, often due to improper operation or suture error and other factors, resulting in more postoperative complications, such as more tissue damage, conjunctival congestion, and muscle suture reaction, which seriously affect the clinical effect of surgical treatment. In recent years, with the continuous development of microsurgical technology, the correction of strabismus under a microscope has been widely carried out in clinic. The operation under the microscope makes the operation more delicate and accurate, overcomes the defects of traditional surgery, and highlights the advantages of minimally invasive surgery. The purpose of this study was to investigate the effect of microsurgical techniques in the treatment of strabismus in children and to analyze the factors influencing the outcome. The results showed that microsurgical strabismus correction in the treatment of strabismus children has short operation time, less intraoperative blood loss, short hospital stay, high efficiency, and less complications, which is worthy of popularization. Age, preoperative strabismus angle, refractive error, distance stereopsis injury, near stereoscopic injury, and duration of disease were all independent influencing factors of postoperative efficacy.

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