Purpose: We aimed to compare clinical characteristics between diplopia-free and diplopia-persistent patients after successful strabismus surgery, when patients complained of diplopia following secondary intraocular lens (IOL) implantation after prolonged aphakia accompanied by sensory strabismus.
Methods: Retrospective review of medical records of patients who complained of diplopia following secondary IOL placement with sensory strabismus after prolonged uncorrected monocular aphakia from isolated ocular trauma was done. We classified patients into two groups according to persistency of diplopia, 6 months after successful strabismus surgery. Clinical characteristics were compared between groups.
Results: A total of 31 patients were included. The diplopia-persistent group showed longer duration of uncorrected aphakia (p = 0.02), less severe corneal astigmatism (p = 0.04), a smaller exodeviation angle (p = 0.02), and more frequent vertical deviation (p = 0.015), extorsion (p = 0.022) and monocular nystagmus (p = 0.028) than the diplopia-free group. In all patients in the diplopia-free group, diplopia could be eliminated prior to strabismus surgery using loose prisms in free space, whereas seven patients in the diplopia-persistent group prior to surgery could not resolve diplopia.
Conclusions: Our data will be helpful for ocular surgeons in determining whether to insert secondary IOL in prolonged aphakia with sensory strabismus, or whether strabismus surgery will eliminate diplopia that develops following secondary IOL placement in this situation.
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http://dx.doi.org/10.1007/s00417-015-3223-8 | DOI Listing |
Acta Med Philipp
November 2024
Department of Ophthalmology and Visual Sciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Background And Objective: There is no strict by-the-book rule as to which approach is the best strabismus surgery for patients with sensory exotropia. More commonly, a monocular lateral rectus recession and a medial rectus resection (monocular R & R; MRR) is performed in the eye with a poorer prognosis. Rarely, for larger deviations, a third or fourth horizontal muscle in the better eye is added.
View Article and Find Full Text PDFAm J Ophthalmol
January 2025
Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address:
Introduction: Botulinum toxin is an alternative to conventional strabismus surgery for treatment for acute, acquired, comitant esotropia (AACE). Previous studies suggest that the two treatment approaches may be equally effective for 6 months. The purpose of our study was to determine whether botulinum toxin remains as effective as strabismus surgery for 36 months after treatment.
View Article and Find Full Text PDFJ Pediatr Ophthalmol Strabismus
December 2024
Purpose: To compare the results of botulinum toxin A injection and bridge Faden operation performed with bimedial rectus recession in the treatment of large-angle esotropia.
Methods: The medical charts of patients with large-angle esotropia who underwent bimedial rectus recession combined with the Faden operation or botulinum toxin A injection between January 2018 and March 2022 were retrospectively screened. The degree of deviations measured before surgery and at 1, 3, 6, and 12 months after surgery were compared between the two groups.
Purpose: To compare changes of vertical palpebral fissure height after bilateral lateral rectus (BLR) recessions versus unilateral lateral rectus (LR) recession and medial rectus (MR) muscle scleral plication, for treatment of intermittent exotropia.
Methods: This prospective, comparative, randomized study included 40 patients with intermittent exotropia who were divided into two groups: 20 patients who underwent BLR recessions (BLR recession group) and 20 patients who underwent unilateral LR recession and MR muscle scleral plication (recession-plication group). Eyelid evaluation included measurement of margin reflex distance 1 (MRD1) and margin reflex distance 2 (MRD2) at 1 week, 6 weeks, and 3 months postoperatively.
JAMA Ophthalmol
January 2025
The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: While urban counties maintain higher densities of ophthalmologists than rural counties, the geographic distribution of ophthalmic surgical subspecialists has not yet been elucidated. A potential workforce discrepancy may impact the burden of care faced by rural surgeons.
Objective: To assess the geographic distribution of the ophthalmic subspecialist surgeon workforce and evaluate factors associated with practicing in rural areas.
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