Medial rectus pulley posterior fixation for esotropia with a high AC/A ratio

Clark, Tiana Y.; Clark, Robert A.

doi:10.1016/j.jaapos.2016.09.028

Cited by 3 publications

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“…Imaging studies have demonstrated, however, that the actual loss of tangency is much less than predicted and, in fact, most of the mechanical effect impeding muscle contraction occurs due to a collision between the posterior scleral attachment and the muscle’s pulley sleeve 7 . This improved understanding of the mechanism of action resulted in a modification of the posterior fixation procedure to place the suture directly through the pulley sleeve instead of the sclera 50 , resulting in a much safer procedure that accomplished similar results 25, 26 .…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of the Globe-Tendon Interface for Extraocular Muscles: Is There an “Arc of Contact”?

Clark

Demer

2018

American Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of the Globe-Tendon Interface for Extraocular Muscles: Is There an “Arc of Contact”?

Clark

Demer

2018

American Journal of Ophthalmology

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Accommodative esotropia: the state of the art

et al. 2018

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Accommodative Esotropia (AE) is a form of strabismus characterized by convergent misalignment of the visual axes that can be associated with hyperopia and abnormal fusional divergence. Also abnormal accommodative convergence/accommodation ratio could be found. In lots of cases, AE initially presents as an intermittent esodeviation at age 1.5 to 4 years. The prevalence of AE has been estimated near 1-2% in the United States. The only treatment with an optical correction usually is successful in re-establishing alignment, but surgical correction is necessary in approximately 30% of cases.

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Long-term Ocular Alignment and Sensory Outcomes After Medial Rectus Recession for High AC/A Ratio Esotropia

Mohan,

Sharma

2024

J Pediatr Ophthalmol Strabismus

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Purpose: To report long-term ocular alignment and sensory outcomes after medial rectus recession for high accommodative convergence/accommodation (AC/A) ratio esotropia. Methods: The medical records of consecutive patients who had undergone unilateral or bilateral medial rectus recession for high AC/A ratio esotropia and were observed postoperatively for a minimum of 5 years were reviewed retrospectively. Results: A total of 34 patients were included. Twenty-three patients (68%) used bifocals preoperatively. The mean age at surgery was 11.5 ± 4.4 years (range: 2.5 to 19.0 years). The mean postoperative follow-up was 7.5 ± 2.3 years (range: 5.0 to 15.25 years). Overall, 21 patients (62%) had surgical success at their last follow-up visit. Age at surgery, preoperative angle of distance and near deviation, distance-near disparity, and preoperative bifocal wear did not predict motor outcome after surgery. Preoperative presence of peripheral binocular single vision was a significant favorable factor for surgical success. At the last follow-up visit, 21% of patients had a recurrence of high AC/A ratio esotropia and 9% each had consecutive exotropia (intermittent [3%] and constant [6%]) and basic esotropia. Peripheral binocular single vision was achieved in 64% of patients and stereopsis in 28%. Bifocal segment was eliminated postoperatively in 70% of patients. Conclusions: Nearly two-thirds of patients with high AC/A ratio esotropia achieved a successful long-term motor outcome and peripheral binocular single vision, and nearly one-fourth achieved stereopsis. Recurrence of high AC/A ratio esotropia occurred in some patients, and consecutive exotropia and basic esotropia in a few. Bifocal segment was eliminated postoperatively in 70% of patients. [ J Pediatr Ophthalmol Strabismus . 20XX;X(X):XX–XX.]

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Medial rectus pulley posterior fixation for esotropia with a high AC/A ratio

Cited by 3 publications

References 4 publications

Magnetic Resonance Imaging of the Globe-Tendon Interface for Extraocular Muscles: Is There an “Arc of Contact”?

Magnetic Resonance Imaging of the Globe-Tendon Interface for Extraocular Muscles: Is There an “Arc of Contact”?

Accommodative esotropia: the state of the art

Long-term Ocular Alignment and Sensory Outcomes After Medial Rectus Recession for High AC/A Ratio Esotropia

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