Biomaterial Database

Complicated strabismus and adjustable sutures. 1988

J A Pratt-Johnson

Department of Ophthalmology, B.C. Children's Hospital, Vancouver, Canada.

Clinical experience in performing over 500 adjustable strabismus operations is mentioned in this paper particularly as it relates to complicated strabismus. A maximum hang-loose recession of a rectus muscle has a limited effect, which is tabulated and the implications discussed. Aids in finding the lost medial rectus muscle are mentioned. Adjustable sutures are then exploited in managing the found "lost" medial rectus. Adjustable recession of both vertical recti in the affected eye were used in some cases of blow-out fracture to manage limitations of upward and downward gaze. Adjustable recession of both yoke medial recti are used in some unilateral superior oblique palsies where the main sequela is hypertropia in downward gaze only. A previously paralysed lateral rectus muscle, which has completely recovered function but has left the patient with a concomitant esotropia with full ductions and normal versions, responds excessively to resection. This should be taken into consideration when planning adjustable strabismus surgery in such a case.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D009801	Oculomotor Muscles	The muscles that move the eye. Included in this group are the medial rectus, lateral rectus, superior rectus, inferior rectus, inferior oblique, superior oblique, musculus orbitalis, and levator palpebrae superioris.	Extraocular Muscles,Extraocular Rectus Muscles,Inferior Oblique Extraocular Muscle,Inferior Oblique Muscles,Levator Palpebrae Superioris,Musculus Orbitalis,Oblique Extraocular Muscles,Oblique Muscle, Inferior,Oblique Muscle, Superior,Oblique Muscles, Extraocular,Rectus Muscles, Extraocular,Superior Oblique Extraocular Muscle,Superior Oblique Muscle,Extraocular Muscle,Extraocular Muscle, Oblique,Extraocular Muscles, Oblique,Extraocular Oblique Muscle,Extraocular Oblique Muscles,Extraocular Rectus Muscle,Inferior Oblique Muscle,Muscle, Oculomotor,Muscles, Oculomotor,Oblique Extraocular Muscle,Oblique Muscle, Extraocular,Oblique Muscles, Inferior,Oblique Muscles, Superior,Oculomotor Muscle,Rectus Muscle, Extraocular,Superior Oblique Muscles
D009886	Ophthalmoplegia	Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles.	Oculomotor Paralysis,External Ophthalmoplegia,Internal Ophthalmoplegia,Ophthalmoparesis,External Ophthalmoplegias,Internal Ophthalmoplegias,Ophthalmopareses,Ophthalmoplegia, External,Ophthalmoplegia, Internal,Ophthalmoplegias,Ophthalmoplegias, External,Ophthalmoplegias, Internal,Paralysis, Oculomotor
D009917	Orbital Fractures	Fractures of the bones in the orbit, which include parts of the frontal, ethmoidal, lacrimal, and sphenoid bones and the maxilla and zygoma.	Blow Out Fracture,Blow-Out Fractures,Fractures, Blow-Out,Orbital Fracture,Blow Out Fractures,Blow-Out Fracture,Fracture, Blow Out,Fracture, Blow-Out,Fracture, Orbital,Fractures, Blow Out,Fractures, Orbital,Out Fracture, Blow,Out Fractures, Blow
D010243	Paralysis	A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)	Palsy,Plegia,Todd Paralysis,Todd's Paralysis,Palsies,Paralyses,Paralysis, Todd,Paralysis, Todd's,Plegias,Todds Paralysis
D012086	Reoperation	A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.	Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D003389	Cranial Nerve Diseases	Disorders of one or more of the twelve cranial nerves. With the exception of the optic and olfactory nerves, this includes disorders of the brain stem nuclei from which the cranial nerves originate or terminate.	Cranial Neuropathies,Cranial Neuropathies, Multiple,Neuropathies, Cranial,Cranial Nerve Disorders,Cranial Nerve Palsies,Nervus Cranialis Disorders,Cranial Nerve Disease,Cranial Nerve Disorder,Cranial Nerve Palsy,Cranial Neuropathy,Cranial Neuropathy, Multiple,Multiple Cranial Neuropathies,Multiple Cranial Neuropathy,Nervus Cranialis Disorder,Neuropathies, Multiple Cranial,Neuropathy, Cranial,Neuropathy, Multiple Cranial,Palsies, Cranial Nerve,Palsy, Cranial Nerve
D004948	Esotropia	A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze.	Esophoria,Strabismus, Convergent,Strabismus, Internal,Convergent Strabismus,Cross-Eye,Esodeviation,Intermittent Esotropia,Internal Strabismus,Monocular Esotropia,Primary Esotropia,Secondary Esotropia,Cross Eye,Cross-Eyes,Esodeviations,Esophorias,Esotropia, Intermittent,Esotropia, Monocular,Esotropia, Primary,Esotropia, Secondary,Esotropias,Intermittent Esotropias,Monocular Esotropias,Primary Esotropias,Secondary Esotropias
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000010	Abducens Nerve	The 6th cranial nerve which originates in the ABDUCENS NUCLEUS of the PONS and sends motor fibers to the lateral rectus muscles of the EYE. Damage to the nerve or its nucleus disrupts horizontal eye movement control.	Cranial Nerve VI,Sixth Cranial Nerve,Abducent Nerve,Nerve VI,Nervus Abducens,Abducen, Nervus,Abducens, Nervus,Abducent Nerves,Cranial Nerve VIs,Cranial Nerve, Sixth,Nerve VI, Cranial,Nerve VIs,Nerve VIs, Cranial,Nerve, Abducens,Nerve, Abducent,Nerve, Sixth Cranial,Nerves, Sixth Cranial,Nervus Abducen,Sixth Cranial Nerves