Modified Y-splitting Procedure for the Treatment of Duane Retraction Syndrome

Objectives: To present the outcomes of modified lateral rectus Y-splitting combined with either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome (DRS) with significant upshoot or downshoot. Materials and Methods: A total of 12 patients including 10 patients with Type I DRS and 2 with Type III DRS underwent modified Y-splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intraoperative adjustable suture technique. Preoperatively 3 patients had esotropia (ET), 6 had exotropia (XT), and 3 patients had orthotropia. The mean preoperative deviation was 19.3 prism diopters (PD) (range, 18-20 PD) in ET patients and 19.2 PD (range, 16-20 PD) in XT patients. Results: Postoperatively, all patients had significant correction in horizontal deviation and aligned within 4 PD of orthotropia, and no patients exhibited abnormal head posture. Co-contraction and globe retraction were markedly reduced and abnormal ocular vertical movement disappeared or significantly decreased in all cases. No patients experienced recurrence of ocular motility disorders in the mean 26-month (range, 13-66 months) follow-up period. Conclusion: Modified Y-splitting surgery combined with co-contracting horizontal muscle recession technique seems to be a safe and effective treatment in DRS. (Turk J Ophthalmol 2015; 45: 152-155

Comparison of limbal conjunctival autograft and amniotic membrane transplantation in ptergium surgery

Amaç: Primer pterjiyum cerrahisinde limbal konjunktival otogreft nakli ve amniyotik mem- bran transplantasyonu yöntemlerinin sonuçlarının karşılaştırılması Gereç ve Yöntem: Primer pterjiyum tanısı alan 50 hastanın 51 gözü çalışmaya dahil edil- di. Hastalar rastgele seçilmek üzere 31 göze limbal konjunktival otogreft nakli, 20 göze amni- yotik membran transplantasyonu yapıldı. Hastaların postoperatif 1. gün, 1. hafta, 2. hafta ve 4. haftalarda ve sonrasında 3 aylık sürelerle takipleri yapıldı. Bulgular: Limbal konjunktival otogreft nakli uygulanan 31 gözden 4’ünde (%12.9), amni- yotik membran transplantasyonu yapılan 20 gözden 2’sinde (%10) nüks gelişti. İki grup ara- sındaki bu farklılık istatistiksel olarak anlamlı değildi (p>0,05). Pterjiyum cerrahisi sonrasın- da nüksler konjunktival otogreft naklinde ortalama 5.5 ay, amniyon membran transplantasyo- nu yapılan gözlerde ortalama 7.5 ay sonra görüldü. Limbal konjunktival otogreft uygulanan 31 gözden birinde piyojenik konjunktival granülom, bir hastada korneal dellen gelişti. Amniyon membran grubunda iki nüks dışında herhangi bir patolojiye rastlanmadı. Sonuçlar: Çalışmada amniyon membran greftinin rekürrensi azaltmakta limbal konjonkti- val otogrefti kadar etkili olduğu görülmüş olup pterjiyum cerrahisine alternatif olabilir.Aim: To compare the results of the two different methods in primary pterygium surgery, limbal conjunctival autograft and amniotic membrane transplantation. Material and Method: Fifty one eyes of the 50 patients with the diagnosis of the primary ptergium were included in the study. The patients were randomly assigned, and limbal con- junctival autograft were performed to the 31 eyes and amniotic membrane transplantation were performed to the remaining 20 eyes. Follow-up visits were performed at weeks 1, 2 and 4 and then 3 months intervals, postoperatively. Results: Recurrence rates of limbal conjunctival autograft and amniotic membrane trans- plantation surgery were 12,9% (4) and 10% (2), respectively. The difference between two groups was not significant (p>0.05). After pterygium surgery, the recurrences occurred within a mean of 5.5 months later in patients underwent conjunctival autograft and within a mean of 7.5 months later in patients underwent amnion membrane transplantation. In limbal conjunc- tival autograft group, one patient had pyogenic conjunctival granuloma, and in another pa- tient corneal dellen was observed. In amnion membrane transplantation group, no complica- tion was observed except two recurrences. Conclusion: We conclude that amnion membrane transplantation is as effective as the lim- bal conjunctival autograft surgery. It likely decreases the recurrences and it may be an alter- native to the other methods