Combined Lateral Rectus Myectomy and Maximal Medial Rectus Resection in Complete Third Cranial Nerve Palsy

This study was performed to describe lateral rectus myectomy and maximal medial rectus resection for correction of eye deviation in complete third cranial nerve palsy. A retrospective review of thirteen patients (fourteen eyes) with complete third cranial nerve palsy, who underwent lateral rectus myectomy and maximal medial rectus resection, was performed. These procedures were combined with superior oblique tendon transposition in nine patients with a large angle of exotropia (more than 60 prism diopters [∆]), or significant hypotropia (more than 5 ∆). Preoperative deviations were exotropia of 50 to 120 ∆ in thirteen cases and hypotropia of 5 to 25 ∆ in eight cases. Six months after the surgery, eleven patients were within 10 ∆ of orthotropia in primary position. Revision surgery was performed for two patients, eight and 18 months after the first operation. Eventually, five patients (38%) achieved orthotropia in the primary position, and seven patients (54%) had < 11 ∆ exotropia and < 6 ∆ vertical deviation. In conclusion, this procedure can be considered as an acceptable approach for treatment of strabismus in complete third cranial nerve palsy. This procedure is simple and can be easily performed even in very young children.Â

Combined Lateral Rectus Myectomy and Maximal Medial Rectus Resection in Complete Third Cranial Nerve Palsy

This study was performed to describe lateral rectus myectomy and maximal medial rectus resection for correction of eye deviation in complete third cranial nerve palsy. A retrospective review of thirteen patients (fourteen eyes) with complete third cranial nerve palsy, who underwent lateral rectus myectomy and maximal medial rectus resection, was performed. These procedures were combined with superior oblique tendon transposition in nine patients with a large angle of exotropia (more than 60 prism diopters [∆]), or significant hypotropia (more than 5 ∆). Preoperative deviations were exotropia of 50 to 120 ∆ in thirteen cases and hypotropia of 5 to 25 ∆ in eight cases. Six months after the surgery, eleven patients were within 10 ∆ of orthotropia in primary position. Revision surgery was performed for two patients, eight and 18 months after the first operation. Eventually, five patients (38%) achieved orthotropia in the primary position, and seven patients (54%) had < 11 ∆ exotropia and < 6 ∆ vertical deviation. In conclusion, this procedure can be considered as an acceptable approach for treatment of strabismus in complete third cranial nerve palsy. This procedure is simple and can be easily performed even in very young children.

Unilateral Duane Retraction Syndrome Associated with Unilateral Congenital Cataract

Purpose: To report unilateral congenital cataract in a case of ipsilateral Duane retraction syndrome. Case Report: In this case, we present a six year old girl who was referred with ocular deviation. She had a history of congenital cataract surgery in the left eye at the age of two years. The subject had no associated systemic disease, developmental delay, or positive family history. She was finally diagnosed as having Duane retraction syndrome in the same eye. Conclusion: Duane retraction syndrome can be associated with congenital cataract due to the matching time of gestational development of the lens to that of ocular and nonocular anomalies associated with Duane syndrome. As both of these disorders are rare, coincidence of both in the same person and the same eye by chance is a very remote possibility

Levodopa Plus Occlusion Therapy versus Occlusion Therapy Alone for Children with Anisometropic Amblyopia

Purpose: This study aimed to compare the effects of short-term administration of levodopa plus occlusion therapy versus occlusion therapy alone in preschool children with hyperopic anisometropic amblyopia. Methods: This comparative interventional study included 40 eligible preschool children aged 6 to 7 years with hyperopic anisometropic amblyopia. The primary outcome measure was the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity recorded at baseline, 3 weeks after the treatment initiation and 12 weeks after the treatment termination. The results were compared between the two groups. Results: No statistically significant intergroup difference was observed in baseline logMAR visual acuities (P = 0.92). The mean logMAR visual acuities of the amblyopic eyes were significantly better in both groups three weeks after the treatment initiation than the baseline (P < 0.01 in both groups). At 12 weeks after treatment termination, the logMAR visual acuities of the amblyopic eyes were significantly better than the baseline values (P < 0.001 in the placebo group and P = 0.09 in the levodopa group). Intergroup comparisons revealed no statistically significant difference in visual acuities 3 weeks after the treatment initiation (P = 0.11) and 12 weeks after the treatment termination (P = 0.10). Twelve weeks after the treatment termination, visual acuities regressed 0.037 logMAR in the placebo group and 0.042 logMAR in the levodopa group. These regression rates were not significantly different (P = 0.89). Conclusion: The results of this study provide evidence that adding short-term administration of levodopa to occlusion therapy in hyperopic anisometropic amblyopia offers no additional benefit in visual outcomes and provides no advantage in terms of the regression rate

Long-term Visual and Refractive Outcomes of Argon Laser-treated Retinopathy of Prematurity

Purpose: In this case–control study, we measured visual acuity, objective refraction, ocular biometric parameters, and strabismus in premature cases classified according to the following categories: argon laser-treated retinopathy of prematurity (ROP), untreated spontaneously regressed ROP, no ROP, and full term controls. Methods: Cases with a history of prematurity at six years of age were categorized into the following groups: patients with a history of treated type 1 ROP using argon laser (group I), untreated spontaneously regressed ROP (group II), and no history of ROP (group III). Group IV included age-matched healthy full-term controls. Funduscopy was performed for all the cases and the control group. Results: In total, 24 eyes of 12 laser-treated ROP cases, 186 eyes of 93 spontaneously regressed ROP patients, 74 eyes of 37 premature cases with no history of ROP, and 286 eyes of 143 controls were included in the study. The mean spherical equivalent in the treated cases was not significantly different from that in the untreated cases and patients in group III. However, the average cylindrical power was significantly different among the groups (P < 0.004). Furthermore, anisometropia (≥1.5 diopter) was diagnosed with a higher rate in the treated cases (P = 0.03). The corneal curvature of the laser-treated eyes was significantly steeper and the axial length was significantly shorter than those in the other groups (P < 0.002 and P < 0.001, respectively, for multivariate analysis). Strabismus was found in three treated patients (25%). Additionally, there were three treated eyes (12.5%) diagnosed with macular dragging. Conclusion: Premature cases including those who had a history of argon laser-treated ROP and those with untreated spontaneously regressed ROP showed acceptable long-term visual and refractive outcomes along with a fairly low rate of ocular disorders

Case report: Mirror-image hypermetropic anisometropia in nontwin brothers

Mirror-image is a term to describe a physical characteristic of some identical twins that appear asymmetrically on opposite sides as if they are looking in a mirror. Mirror-image anisometropia in monozygotic twins was previously reported in the ophthalmic literature. In this article, we describe a case of mirror-image hypermetropic anisometropia in siblings aged 8 and 5 years old. Nontwin brothers, 8 and 5 years old, with mirror-image hypermetropic anisometropia, were referred to the pediatric ophthalmology clinic. Corrected distant visual acuity was 20/20 (ocula dextra [OD]), 20/60 (ocula sinistra [OS]) in the older brother, and 20/50 (OD), 20/20 (OS) in the younger brother. Cycloplegic refraction was + 3.5 − 1.25 × 180 (OD), +7.75 − 1.5 × 30 (OS), and + 7.0 − 0.75 × 20 (OD), +2.0 − 1.0 × 170 (OS) in the older and younger brother, respectively. The axial length difference between the two eyes was 1.47 mm in the older and 2.01 mm in the younger brother. Hypermetropic anisometropia that may lead to anisometropic amblyopia may happen in nontwin brothers. This emphasizes the importance of complete ophthalmologic examination in the siblings of all patients with anisometropia

Unilateral Duane Retraction Syndrome Associated with Unilateral Congenital Cataract

Purpose: To report unilateral congenital Cataract in a case of ipsilateral Duane retraction syndrome. Case Report: In this case, we present a six year old girl who was referred with ocular deviation. She had a history of congenital Cataract surgery in the left eye at the age of two years. The subject had no associated systemic disease, developmental delay, or positive family history. She was finally diagnosed as having Duane retraction syndrome in the same eye. Conclusion: Duane retraction syndrome can be associated with congenital Cataract due to the matching time of gestational development of the lens to that of ocular and nonocular anomalies associated with Duane syndrome. As both of these disorders are rare, coincidence of both in the same person and the same eye by chance is a very remote possibility

Erratum to Long-term Visual and Refractive Outcomes of Argon Laser-treated Retinopathy of Prematurity

This is an Erratum to Long-term Visual and Refractive Outcomes of Argon Laser-treated Retinopathy of Prematurity. Please download the PDF or view the article HTML