Correction of exotropia and improved adduction by fixation of the anterior encircling fascia to the medial rectus insertion site following myectomy of the four horizontal rectus muscles for infantile nystagmus.

Myectomy of the four horizontal rectus muscles for infantile nystagmus syndrome without a null point may improve visual acuity and quality of life. Exotropia and adduction loss are complications of this procedure, although abduction is typically preserved. We investigated whether adduction loss may be rescued by reestablishing the attachment of the anterior intermuscular septum (AIMS) to the globe at the medial rectus insertion.

Myectomy of the four horizontal rectus muscles with pulley fixation for the treatment of horizontal nystagmus in 10 adults: a pilot study.

Purpose: Myectomy and release of the four horizontal rectus muscles can ameliorate nystagmus, but may result in adduction limitation, convergence insufficiency, or exotropia. We developed a modified four-muscle myectomy with pulley fixation, in which the myectomized muscles are attached to the pulley rather than released. The purpose of this study was to present a prospective review of the clinical, nystagmographic, and quality-of-life data in a cohort of adults.

Myectomy of the Extraocular Muscles Without Reattachment as a Surgical Treatment for Horizontal Nystagmus.

Purpose: To report the comparative clinical findings for two nystagmus procedures in two consecutive case series: the Sinskey anterior extirpation procedure (SAEP) and a modification, myectomy without reattachment (MWR).

Methods: Twenty consecutive patients underwent the SAEP and 19 underwent MWR. The SAEP is a snare-assisted unmeasured deep myectomy, whereas MWR is a measured myectomy at posterior Tenon's fascia.

Reliability and application variability of a commercially available infrared videonystagmography unit.

Purpose: Nystagmus is a condition of involuntary eye movement. The causes for nystagmus may be congenital, idiopathic, or acquired. Considerable debate exists on the therapeutic potential of various surgical techniques.

Laser in situ keratomileusis to correct residual myopia and astigmatism after radial keratotomy.

Purpose: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) in selected post-radial-keratotomy (RK) eyes with residual myopia and astigmatism.

Setting: TLC-The Brea Laser Eye Center, Brea, California, USA.

Methods: Nine eyes of 6 patients who had had RK but had residual myopia and/or astigmatism had LASIK.

Topical intrastromal steroid during laser in situ keratomileusis to retard interface keratitis.

Purpose: To evaluate the effect of an intraoperative topical intrastromal steroid on the incidence and severity of nonspecific diffuse intralamellar keratitis (NSDIK).

Setting: T.L.

Contrast sensitivity in dyslexia.

Contrast sensitivity was determined for dyslexic and normal readers. When testing with temporally ramped (i.e.

Cataract extraction and intraocular lens implantation in an infant with a monocular congenital cataract.

A cataract extraction and primary capsulotomy with intraocular lens (IOL) implantation was performed on a 17-day-old infant with a monocular mature congenital cataract. The IOL power, calculated at the time of surgery, was undercorrected to compensate for the growth of the eyeball. Two additional surgical procedures were required to resolve visual axis obstruction caused by lens epithelial cell proliferation.

Intraoperative succinylcholine and the postoperative eye alignment.

In 99 patients undergoing strabismus surgery, an intravenous bolus of succinylcholine (Sch) was given after completion of the strabismus procedure. Reliable data were obtained in 53 patients. The interlimbal distance measured at 60 seconds after injection (VR60) was compared to the interlimbal distance at 1 and 6 weeks postoperatively, to evaluate the correlation between the drug-induced eye position under anesthesia and the awake-eye alignment postoperatively.

Synergistic divergence: saccadic velocity analysis and surgical results.

The clinical findings are described in four patients with synergistic divergence (SD), an ocular motility disorder which is considered to be a variant of Duane retraction syndrome (DRS). Saccadic velocity studies in three patients demonstrated preserved abducting saccades in the affected eye with equally reduced amplitudes on both attempted abduction and adduction. The preserved saccades on attempted abduction of the affected eye, coupled with electromyographic evidence that shows maintenance of normal reciprocal innervation with respect to gaze on attempted abduction as dictated by Sherrington's law, strongly suggest that the abducens nerve is not necessarily absent or severely hypoplastic in this condition.

Succinylcholine-stimulated muscle tensions following botulinum injection in the domestic cat.

Succinylcholine (SCh) selectively stimulates, and can therefore selectively assay, the multiple innervated (MI) fiber system of the extraocular muscles. Since botulinum-A toxin has been observed to induce changes in eye position in humans, SCh was used to assess the effect of botulinum-A on the SCh-sensitive MI fibers of extraocular muscles. Intravenous SCh infusion (40 micrograms-1 kg-1 min-1 was performed in the anesthetized domestic cat.

Synergistic divergence and jaw-winking phenomenon.

Synergistic divergence is a congenital syndrome of monocular adduction deficit, with simultaneous abduction of both eyes on attempted gaze into the field of action of the paretic medial rectus muscle. Based on electromyographic data, it has been speculated that it is a neural miswiring disorder related to Duane's retraction syndrome. The association between Duane's retraction syndrome and the Marcus Gunn jaw-winking phenomenon, another neural miswiring disorder, has been previously reported.

Thyroid eye disease presenting after cataract surgery.

Strabismus presenting after cataract surgery has been attributed to a variety of disorders, some of which are unrelated to the surgery. When thorough ophthalmologic and neurologic examinations fail to elucidate a definitive etiology, the motility disturbance is often ascribed to operative trauma to the orbital soft tissues. In a series of 58 patients with strabismus presenting after cataract surgery, eight (14%) were found to have previously unsuspected thyroid eye disease.

A caliper-hook for strabismus surgery.

An instrument to assist in resection surgery consists of a telescoping hook within a second hook that can be spread a calibrated distance. Its primary purpose is to maintain a constant tension and an accurate measure of tendon length during suture passage. Additionally, the grooved distal hook supports the needle and protects the globe from needle trauma.

Reliability and variability in the measurement of interlimbal distance with a semiautomated video replay analysis system (SAVRAS).

This paper reports on the reliability and variability of a semi-automated, video replay and analysis system (SAVRAS) in determining interlimbal distance in patients with strabismus. Factors under investigation were: choice of observer, choice of video frame, patient age and patient state (awake or anesthetized). It was demonstrated that SAVRAS was a highly reliable and reproducible system.

A comparison of the succinylcholine induced ocular position and the postoperative alignment in strabismus.

Succinylcholine was injected intraoperatively in 41 strabismus patients with congenital esotropia or intermittent or constant exotropia. Regression analyses were performed to investigate the predictive relationships between the one-, six-, and 26-week postoperative alignment and the intraoperative, succinylcholine-induced ocular position. Ocular position, determined by the interlimbal distance in millimeters, was calculated using a semi-automated, video replay analysis system.