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Insertion Slanting Strabismus Surgical Procedures

Insertion Slanting Strabismus Surgical Procedures SPECIAL ARTICLE Burton J. Kushner, MD nsertion slanting recessions or biased resections have been reported to be useful for treat- ing A- and V-pattern strabismus, convergence insufficiency, and convergence excess eso- tropia. Paradoxically, good results have been reported with methods that are opposite in I nature. For example, some researchers would recess the medial rectus muscles and slant the superior pole of each muscle back farther than the inferior pole (Simonsz/von Graefe method) for a V-pattern esotropia, and others would slant the inferior poles back farther (Bietti method). The Simonsz/von Graefe method seems to be based on sound concepts of oculomotor mechanics. The Bietti method has been justified based on a misquoting and misinterpretation of previous work by Alan Scott, MD. Probably neither method contributes substantially to the outcome of strabis- mus surgery because sarcomere remodeling should rapidly negate the effect of the slanting. Most likely it is the recession or resection itself that affects the outcome. Arch Ophthalmol. 2011;129(12):1620-1625 The terms A-pattern and V-pattern stra- have been most predominantly used: (1) bismus are used to describe vertically in- weakening of the oblique muscles if they comitant horizontal strabismus in which are overacting (inferior oblique muscles for there is http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Ophthalmology American Medical Association

Insertion Slanting Strabismus Surgical Procedures

JAMA Ophthalmology , Volume 129 (12) – Dec 1, 2011

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References (40)

Publisher
American Medical Association
Copyright
Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6165
eISSN
2168-6173
DOI
10.1001/archophthalmol.2011.326
pmid
22159685
Publisher site
See Article on Publisher Site

Abstract

SPECIAL ARTICLE Burton J. Kushner, MD nsertion slanting recessions or biased resections have been reported to be useful for treat- ing A- and V-pattern strabismus, convergence insufficiency, and convergence excess eso- tropia. Paradoxically, good results have been reported with methods that are opposite in I nature. For example, some researchers would recess the medial rectus muscles and slant the superior pole of each muscle back farther than the inferior pole (Simonsz/von Graefe method) for a V-pattern esotropia, and others would slant the inferior poles back farther (Bietti method). The Simonsz/von Graefe method seems to be based on sound concepts of oculomotor mechanics. The Bietti method has been justified based on a misquoting and misinterpretation of previous work by Alan Scott, MD. Probably neither method contributes substantially to the outcome of strabis- mus surgery because sarcomere remodeling should rapidly negate the effect of the slanting. Most likely it is the recession or resection itself that affects the outcome. Arch Ophthalmol. 2011;129(12):1620-1625 The terms A-pattern and V-pattern stra- have been most predominantly used: (1) bismus are used to describe vertically in- weakening of the oblique muscles if they comitant horizontal strabismus in which are overacting (inferior oblique muscles for there is

Journal

JAMA OphthalmologyAmerican Medical Association

Published: Dec 1, 2011

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