Minimal Invasive Procedures in Strabismus Surgery: A Narrative Review.

Purpose: To review the principles and different techniques of minimally invasive procedures in strabismus surgery.

Methods: This is a narrative review on minimally invasive procedures in strabismus surgery including general aspects and different new modifications on conventional strabismus surgery. We reviewed 24 articles published between 1993 and 2020.

Leber's hereditary optic neuropathy: Diagnostic pitfalls in genetic testing.

Purpose: To investigate the possibility and consequences of false positive testing for Leber's hereditary optic neuropathy (LHON) using repeated testing.

Methods: In three cases of suspected LHON, initial mutation analysis using restriction fragment length polymorphism (RFLP) and direct sequencing showed rare mtDNA mutations at nt 14482 in two cases and a mutation in nt 14484 in the third case which has been associated with a mild variant of LHON. All three patients consulted a specialized neuro-ophthalmology center for a second opinion.

Comparison of deep sclerokeratodissection, a new variant of nonpenetrating glaucoma surgery, with deep sclerectomy.

Purpose: The aim of this study was to evaluate the safety and efficacy of deep sclerokeratodissection (DSKD), a new nonpenetrating technique in glaucoma surgery.

Materials And Methods: Retrospective comparison between patients treated with DSKS or deep sclerectomy (DS) between 2013 and 2014. In DSKD, the first and only flap is dissected directly into clear cornea with unroofing Schlemm's canal.

[Early detection and treatment of strabismus].

An early diagnosis of strabismus is important in order to rule out treatable organic causes and in children, if indicated, to start as early as possible with an amblyopia treatment. Early detection will also decrease the risk for accidents secondary to diplopia, to the loss of binocular vision and to the restriction of the binocular visual field in case of esodeviations. The following therapeutic options exist: in some cases the prescription of the correct refraction will be sufficient, for small deviations a prismatic correction may allow a longstanding treatment, for larger or incomitant deviations strabismus surgery will be necessary, which nowadays can be performed using minimal-invasive technique on an outpatient base.

Intraoperative conversion rate to a large, limbal opening in minimally invasive strabismus surgery (MISS).

Background: To evaluate which factors predispose to an intraoperative conversion to the usual limbal approach in minimally invasive strabismus surgery (MISS).

Methods: This study included 451 consecutive patients operated on by one surgeon at Kantonsspital St Gallen, Switzerland, with minimally invasive rectus muscle surgery between February 2003 and December 2007. We evaluated the intraoperative conversion rate to the usual limbal approach over time, and performed a retrospective determination of date of surgery, age of patient, motility of the eye, primary or revision surgery, and the type and dose of surgery in 982 consecutive rectus muscle procedures.

The perception of strabismus by children and adults.

Background: Visible strabismus has been shown to have adverse psychosocial consequences. It remains controversial if esotropia or exotropia is perceived more negatively. The aim of this study was to determine if esotropia or exotropia and the eye (side) in which strabismus is present are perceived differently.

Strabismus and discrimination in children: are children with strabismus invited to fewer birthday parties?

Aim: To determine the social acceptance of children with strabismus by their peers and to determine the age at which the negative impact of strabismus on psychosocial interactions emerges.

Methods: Photographs of six children were digitally altered in order to create pictures of identical twins except for the position of the eyes (orthotropic, exotropic and exotropic) and the colour of the shirt. One hundred and eighteen children aged 3-12 years were asked to select, for each of the six twin pairs, one of the twins to invite to their birthday party.

Combined horizontal rectus muscle minimally invasive strabismus surgery for exotropia.

Objective: To evaluate combined horizontal rectus muscle minimally invasive strabismus surgery (MISS) for exotropia.

Design: Case series.

Participants: Fifty-two consecutive exotropic patients operated on by 1 surgeon with MISS combined unilateral lateral rectus muscle recession and medial rectus muscle plication.

Impact of low vision on employment.

Background: We investigated the influence of self-reported corrected eyesight on several variables describing the perception by employees and self-employed persons of their employment.

Methods: Our study was based on data from the Survey of Health, Ageing and Retirement in Europe (SHARE). SHARE is a multidisciplinary, cross-national database of microdata on health, socioeconomic status, social and family networks, collected on 31,115 individuals in 11 European countries and in Israel.

GD1a-associated pure motor Guillain-Barré syndrome with hyperreflexia and bilateral papillitis.

A patient with acute purely motor polyneuropathy with positive GD1a ganglioside antibodies who presented with paresis in combination with hyperreflexia is reported. Neurophysiological tests revealed features compatible with acute motor axonal neuropathy. Therapy with intravenous immunoglobulin led to rapid clinical improvement.

A modified technique for rectus muscle plication in minimally invasive strabismus surgery.

Purpose: To present a novel, minimally invasive strabismus surgery (MISS) technique for faster and less invasive rectus muscle plication.

Methods: The new plication method is performed without spatula and, therefore, instead of a total dissection (TODI) only a marginal dissection (MADI) of the plicated part of the muscle is performed. Forty patients operated with combined, horizontal MISS rectus muscle recession/MADI plication are retrospectively compared to a similar group of 49 patients, who had MISS recession/TODI plication.

A new transconjunctival muscle reinsertion technique for minimally invasive strabismus surgery.

Purpose: To describe a novel, minimally invasive strabismus surgery (MISS) technique for horizontal rectus muscle recessions, plications, and advancements.

Methods: Subjects for this prospective study were the first 20 consecutive patients who underwent unilateral horizontal rectus muscle surgery with a transconjunctival suturing (TRASU) technique for primary muscle displacements of 4.5 mm or greater or for repeat muscle displacements of 3.

Stimulus parameters for goldmann kinetic perimetry in nonorganic visual loss.

Objective: To investigate the influence of the stimulus parameters on perimetry at various distances and draw conclusions for the clinical exploration of nonorganic visual loss.

Methods: Visual field testing using Goldmann kinetic perimetry was performed on 15 healthy volunteers. The I/1e isopter at 33 cm was compared to the I/1e, II/1e and I/2e isopters at 66 cm.

Minimally invasive strabismus surgery technique in horizontal rectus muscle surgery for esotropia.

Purpose: To evaluate the minimally invasive strabismus surgery (MISS) technique in combined unilateral horizontal rectus muscle operations for esotropia.

Methods: This study included 61 patients operated by one surgeon with MISS medial rectus muscle recession and lateral rectus muscle plication. Alignment, binocular vision, conjunctival injection and swelling as well as complications during the first 6 postoperative months were recorded prospectively.

Antifibrotic effects of tocotrienols on human Tenon's fibroblasts.

Purpose: To compare the antifibrotic effect of vitamin E isoforms alpha-, gamma-, and delta-tocotrienol on human Tenon's fibroblasts (hTf) to the antimetabolite mitomycin C.

Methods: Antifibrotic effects of alpha- (40, 60, 80, 100, and 120 microM), gamma- (10, 20, 30, and 40 microM) and delta-tocotrienol (10, 20, 30, and 40 microM) on hTf cultures were evaluated by performing proliferation, migration and collagen synthesis assays. Whereas for vitamin E the exposure time was set to 7 days to mimic subconjunctival application, cultures were exposed only 5 min to mitomycin C 100 microg/ml to mimic intraoperative administration.

Computer-based test to quantify the Pulfrich stereophenomenon.

Background: Many eye and brain diseases may induce a spontaneous Pulfrich phenomenon (PP), a stereoillusion leading to misjudgments of objects moving in a frontoparallel plane. Since, until now, no simple PP quantification method has been available, a computer pendulum (CP) system was developed and evaluated.

Methods: In 5 normal subjects, PP was induced with different neutral density filters.

A new stereotest for strabismologists: the covered two pencil test.

Purpose: The two pencil test (TPT) checks the ability to perform a simple visual-motor task. The test is only partially based on intact stereopsis, since monocular depth perception clues are involved. To overcome this shortcoming, a new test variant has been developed and tested.

Dietary tocopherol supplementation after trabeculectomy and phacotrabeculectomy: double-blind randomized placebo-controlled trial.

Purpose: The vitamin E compound alpha-tocopherol inhibits fibroblast growth in vitro. To evaluate its potential benefit in preventing failure of glaucoma filtration surgery, we prospectively investigated the outcome of filtering surgery with postoperative dietary alpha-tocopherol supplementation.

Patients And Methods: Thirty-nine patients (39 eyes) with primary open-angle glaucoma or pseudoexfoliative glaucoma were randomly assigned to two post-(phaco)-trabeculectomy treatment groups.

Distance doubling visual acuity test: a reliable test for nonorganic visual loss.

Background: To determine the value of the distance doubling visual acuity test in the diagnosis of nonorganic visual loss in a comparative observational case series.

Methods: Twenty-one consecutive patients with nonorganic visual acuity loss and 21 subjects with organic visual loss as controls were included. Best corrected visual acuity was tested at the normal distance of 5 meters using Landolt Cs.

Minimally invasive strabismus surgery for rectus muscle posterior fixation.

Aims: To present a novel, minimally invasive strabismus surgery (MISS) technique for rectus muscle posterior fixation.

Methods: This study reports the results of 32 consecutive MISS rectus muscle posterior fixation surgeries performed on 19 patients by applying only two small L-shaped openings where the two retroequatorial scleromuscular sutures were placed.

Results: On the first postoperative day, in primary position, redness was hardly visible in 16 eyes (50%) and only moderate redness was visible in 6 eyes (19%).

Strabismus and employment: the opinion of headhunters.

Purpose:  The aim of this study was to determine the influence of strabismus on an individual's ability to find employment based on the opinion of Swiss headhunters.

Methods: Forty Swiss headhunters retrieved from a Swiss online telephone directory were interviewed using a validated questionnaire in order to determine if strabismus would have an impact on a person's ability to find employment. Photographs of a strabismic man and woman as well as of other computer-generated facial anomalies could be downloaded from the Internet during the interview.

Minimally invasive strabismus surgery (MISS) for inferior obliquus recession.

Purpose: To present a novel, minimally invasive strabismus surgery (MISS) technique for inferior obliquus recessions.

Methods: Graded MISS inferior obliquus recessions were performed in 20 eyes of 15 patients by applying two small conjunctival cuts, one at the insertion of inferior obliquus and another where the scleral anchoring of the muscle occurred.

Results: The amount of recession was 12.

Opinion of headhunters about the ability of strabismic subjects to obtain employment.

Background: Through the opinion of Swiss headhunters, we wanted to determine the influence of strabismus on the ability to obtain employment.

Methods: Out of 31 randomly selected Swiss headhunters, 20 could be interviewed using a validated questionnaire.

Results: Forty-seven percent of the headhunters judged that strabismic subjects have more difficulties in obtaining a job.

Performance of a new, 3D-monitor based random-dot stereotest for children under 4 years of age.

Background: The aim of this study was to determine the performance of a new, 3D-monitor based, objective stereotest in children under the age of four.

Methods: Random-dot circles (diameter 10 cm, crossed, disparity of 0.34 degrees) randomly changing their position were presented on an 3D-monitor while eye movements were monitored by infrared photo-oculography.

Waiting times for cataract surgery in ten European countries: an analysis using data from the SHARE survey.

Aims: To assess waiting times for cataract surgery and their acceptance in European countries, and to find explanatory, country-specific health indicators.

Methods: Using data from the survey of health, ageing and retirement in Europe (SHARE), waiting times for cataract surgery of 245 respondents in ten countries were analysed with the help of linear regression. The influence of four country specific health indicators on waiting times was studied by multiple linear regression.