Surgical Management of Strabismus Following Vitreo-Retinal Surgery

Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin 53705, USA.
American Orthoptic Journal 07/2012; 62(1):44-49. DOI: 10.3368/aoj.62.1.44


orders, have been well described. 1– 5 Most commonly, these motility disorders follow scleral buckle repair for retinal detach-ment; however, strabismus has also been described following vitrectomy, pneumatic retinopexy, and cryotherapy alone. 6– 8 While the mechanisms by which stra-bismus develops have not been rigorously studied, it is clear that multiple etiologic factors are often present in the same indi-vidual. In scleral buckling surgery, which will be the focus of this discussion, the pro-posed mechanisms that create strabismus include: sensory disturbance, muscle re-strictions, redirection of muscle forces, direct muscle injury, malpositioning or

Download full-text


Available from: Michael C Struck, Oct 05, 2015
1 Follower
44 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thirty-three consecutive patients with persistent strabismus following retinal detachment surgery were studied retrospectively. A large number of vertical and torsional problems were seen. Various restrictive abnormalities were identified during strabismus surgery. These included superior oblique tendon displacement anteriorly, leash and reverse leash types of restrictions, myoscleral adhesions posterior to the exoplants, and stretching of the muscles induced by large underlying exoplants. The results following strabismus surgery were analyzed. Eighty percent of the patients were able to achieve single binocular vision in the primary field of gaze, with a low incidence of complications. The adjustable suture procedure was thought to be helpful.
    Journal of Pediatric Ophthalmology & Strabismus 01/1987; 24(6):309-14. · 0.75 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Diplopia following retinal detachment usually responds to simple measures. Fifteen out of 311 cases developed diplopia lasting more than three months after conventional retinal detachment surgery. Binocular single vision was restored in 12 of the 15 cases (80%). The mean follow-up was four years. Diplopia was eliminated stepwise. If prisms were ineffective, our first surgical procedure was removal of the scleral buckle. If the retina was flat, we were prepared to remove the buckle early. When diplopia persisted after buckle removal, we proceeded to strabismus surgery. Our most consistent results followed strabismus surgery on the untreated eye. Prisms alone restored binocular single vision in six patients (40%), one of whom preferred to adopt a compensatory head posture. Removal of the scleral buckle restored binocular single vision in three patients (20%), with the help of a prism in one case and a compensatory head posture in another. Binocular single vision was restored after buckle removal and strabismus surgery in three further patients (20%), one requiring a prism in addition. Binocular single vision was not restored in three patients (20%).
    British Journal of Ophthalmology 08/1987; 71(7):521-5. DOI:10.1136/bjo.71.7.521 · 2.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Between 5% and 25% of patients may experience persistent diplopia after surgery for retinal detachment. The complexity of the presentation poses a distinct challenge to both the retinal and the strabismus surgeon. Careful evaluation to determine factors contributing to the strabismus and assessment of fusional capabilities are essential before treatment. A combination of the appropriate surgical approach with nonsurgical adjuncts such as prisms or botulinum toxin is often successful in relieving symptoms.
    Seminars in Ophthalmology 04/1995; 10(1):61-73. DOI:10.3109/08820539509059981 · 0.86 Impact Factor