[Treatment of paralytic strabismus].
1) Cases of strabismus combined with abnormalities in ocular movement were divided into three groups: paralytic nonconcomitant strabismus, special forms of strabismus, and paralytic concomitant strabismus. 977 cases of surgery for paralytic nonconcomitant strabismus were analyzed. 2) 109 cases of surgery for paralytic esotropia due to abducens palsy were performed. In cases of complete paralysis, a transposition of the vertical rectus muscle was indicated. In cases of incomplete paralysis, a resection of the lateral rectus muscle was indicated. On the basis of these indications, the same results could be achieved, and when a recession of the medial rectus muscle was concurrently performed the results were improved. 3) In oculomotor palsy, 138 cases of surgery for paralytic exotropia were performed. In cases of complete paralysis, a transposition of the superior oblique muscle was indicated. In cases of incomplete paralysis, a resection of the medial rectus muscle was indicated. On the basis of these indications, the same results could be achieved, and when a recession of the lateral rectus muscle was concurrently performed the results were improved. 4) 570 cases of surgery for superior oblique muscle palsy were performed. In cases of vertical deviation, a weakening operation on the inferior oblique muscle, the superior rectus muscle of the affected eye, and the inferior rectus muscle of the sound eye were indicated. In cases of torsional deviation, good results were obtained through an advancement of the anterior part of the superior oblique muscle and a resection of the superior oblique muscle. 5) Statistics concerning cure based on the standards for cure employed by the Japanese Association of Strabismus and Amblyopia, or from the point of view of cosmetic cure were: 85% for paralytic esotropia and superior oblique muscle palsy, 82% satisfactory for incomplete paralysis of the oculomotor nerve within paralytic exotropia, and 61% relatively unsatisfactory for complete paralysis of the oculomotor nerve within paralytic exotropia. 6) The results of 216 cases examined after period of four years or longer were: cases where a one-month postoperative cure or cosmetic cure was maintained over this period were 90% of superior oblique muscle palsy cases, 79% of paralytic esotropia, and 59% of paralytic exotropia. Paralytic exotropia showed poor results. The surgical methods were muscle transposition in cases of horizontal muscle surgery and surgery of the oblique muscles in cases of vertical muscle surgery. 7) Through the Turn-Amplitude Analysis of the amounts of EMG interference patterns in the extraocular muscle, neuropathy was classified as either complete or incomplete.(ABSTRACT TRUNCATED AT 400 WORDS)
Maruo
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Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.
D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000150:complications* / Q000601:surgery*; D013285:Strabismus / Q000150:complications* / Q000601:surgery*