What's new AAPOS 2008 - The Private Eye Clinic

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CONCLUSIONS: Topical brimonidine administration before strabismus surgery may reduce intraoperative bleeding and postoperative subconjunctival hemorrhage in adult patients. Inferior oblique muscle fixation into the orbital wall: A profound weakening procedure. Ela-Dalman N, Velez FG, et al. J AAPOS 2007; 11: 17-22. 10 consecutive patients with V- pattern strabismus and/or inferior oblique overaction underwent inferior oblique orbital fixation by attaching its insertion into the periostium of the lateral orbital wall. Both the V-pattern ( pre 22^ to post 7^) and inferior oblique overaction (pre +2.5 to ost +0.1) improved. Advantages of this procedure compared to extirpation, myotomy, and myectomy include the permanent removal of the muscle from the globe which is reversible if needed. Anterior and nasal transposition of the inferior oblique muscles in patients with missing superior oblique tendons. Hussein MA, Stager Sr. DR, et al. . J AAPOS 2007; 11: 29-33. Nine children, 2 unilateral and 7 bilateral, with absent superior oblique tendons underwent anterior and nasal transposition of the inferior oblique muscles. Some cases were combined with horizontal practice muscle surgery. The transposition reduced overelevation in abduction and improved or eliminated divergence in upgaze. Both unilateral cases were orthotropic with no abnormal head position. The bilateral cases were improved but had vertical deviation inside gaze (three patients) and V-pattern esotropia in downgaze (two patients). Use of the combined recession and resection of a rectus muscle procedure in the management of the incomitant strabismus. Dawson E., Boyle N, et al. J AAPOS 2007; 11: 131-134. This is a retrospective review on 22 patients approximately evenly split between paralytic, mechanical/restrictive and residual childhood strabismus patients with gaze incomitance. 20 of the 22 patients had prior surgical procedures. 21 of 22 patients had measurable improvement in the incomitance and 11 of 12 showed improvement of field of binocular single vision. 18
The effect of topical tetracaine eyedrops on the emergence behavior and pain relief after strabismus surgery. Anninger W, Forbes B, et al. J AAPOS 2007; 11: 273-76. The authors performed a double masked randomized controlled trial of 88 patients from one to 12 years of age undergoing strabismus surgery. They had three groups randomized to receive either saline drops before and after surgery, saving drugs before and tetracaine 1% after surgery, and tetracaine drops before and after surgery. They masked observers then assessed each patient in the Post anesthesia care unit. They found that postoperative strabismus surgery pain was lessened by the use of preoperative and pre-and postoperative tetracaine drops. Management of nonresolving consecutive exotropia following botulinum toxin treatment of childhood esotropia. Jaime Tejedor MD PhD, José Rodriguez MD Arch Ophthalmol 2007;125(9):1210-1213 Retrospective medical records review; 2445 patients treated with botulinum toxin bimedial injection; patients operated on after 1 year of consecutive exotropia were selected. A total of 5 children with acquired esotropia and 2 with infantile esotropia were included. A high dose of toxin per injection might increase the risk of consecutive exotropia. Preoperative mean exotropic deviation was 15.42 prism diopters, and stereoacuity was not measurable before surgery. Postoperative mean deviation was 6 PD, and mean stereoacuity was 447.14 arc seconds. In 2 patients, suppression of the nondominant eye was detected. Three children had poor stereoacuity. Conclusion: Surgery for exotropia following botulinum toxin injection in children is effective from a motor and sensory point of view. A 10-year overview of double elevator muscle weakening procedures. Richard Saunders MD, Stacey Kruger MD, Joel Lall-Trail MD, Philip Rust PhD Arch Ophthalmol 2007;125:634-638 Observational case series; 10-year period; consecutive patients who underwent bilateral 5- to 11-mm superior rectus muscle recessions combined with an IO muscle recession, myectomy, or anterior transposition. Effects on ocular rotations and eyelid position were recorded for 37 patients (69 eyes) who were followed up for at least 6 months postoperatively. Supraduction deficiency was significantly associated with transposition of the IO muscle anterior to the inferior rectus muscle insertion compared with the standard IO muscle recession and IO muscle myectomy. Y-pattern exotropia occurred more frequently after transposition of the IO muscle anterior to the inferior rectus muscle insertion than other weakening procedures. 19
Page 1 and 2: What’s New and Important in Pedia
Page 3 and 4: ROP Retinopathy of Prematurity: the
Page 5 and 6: same diagnosis in 4 of 34 images (1
Page 7 and 8: PREMATURITY Perinatal care in the t
Page 9 and 10: STRABISMUS Causes and outcomes for
Page 11 and 12: METHODS: The medical records of all
Page 13 and 14: initial positive response to medica
Page 15 and 16: deviation as an intermittent exodev
Page 17: STRABISMUS SURGERY Unilateral reces
Page 21 and 22: +/-0.08 and 0.34 +/-0.07 mm, for th
Page 23 and 24: THYROID Cigarette smoking and thyro
Page 25 and 26: excluding from the cataract group t
Page 27 and 28: Long-Term Results of Lensectomy in
Page 29 and 30: CATARACT SURGERY Pediatric anterior
Page 31 and 32: Suture-related complications after
Page 33 and 34: included vitrectomy, capsulotomy, c
Page 35 and 36: medication. At the last follow-up,
Page 37 and 38: REFRACTIVE ERROR / REFRACTIVE SURGE
Page 39 and 40: demonstrated a positive effect on t
Page 41 and 42: ANTERIOR SEGMENT Conjunctival Melan
Page 43 and 44: RESULTS: Directly after birth, corn
Page 45 and 46: and photophobia (80%). The children
Page 47 and 48: Validity and reliability of the Chi
Page 49 and 50: outcomes achieved at cessation of t
Page 51 and 52: METHODS: One hundred and thirteen c
Page 53 and 54: Verisyse intraocular lens implantat
Page 55 and 56: GENETICS Marfan syndrome: from mole
Page 57 and 58: Visual outcome of a cohort of child
Page 59 and 60: primarily affect the photoreceptors
Page 61 and 62: single morphogenetic anomaly in dev
Page 63 and 64: Three genome-wide association studi
Page 65 and 66: • Cafe-au-lait macules • Freckl
Page 67 and 68: Laryngeal and tracheal anomalies Po
Page 69 and 70:
Treatment of retinoblastoma: Curren
Page 71 and 72:
Secondary acute myeloid leukemia af
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one. Patients treated with radiatio
Page 75 and 76:
Neuro-ophthalmological management o
Page 77 and 78:
CONCLUSION: Canalicular involvement
Page 79 and 80:
peripheral retinal vasculitis. The
Page 81 and 82:
This article describes a 7-month-ol
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eference eyes. Photopic flash ERGs
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RESULTS: In models that adjusted fo
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ORBIT Porous orbital implants, wrap
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PLASTICS Conjunctival epithelial ch
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The authors conclude that lash ptos
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.03). SBP and DBP were significantl
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CONGENITAL INFECTION Congenital lym
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PEDIATRICS Visual Manifestations of
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controversial, ranging from one to
Page 101 and 102:
SYSTEMIC Visual function and ocular
Page 103 and 104:
Toxocara infection. Toxocara GWC an
Page 105 and 106:
congenital cataracts. The retina wa
Page 107 and 108:
Childhood blindness: a UK epidemiol
Page 109:
safe and efficient procedure to cor
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