Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2002
[Adjustment of eye muscle surgery dosage under drop anaesthesia in patients with Grave's orbitopathy].
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Kalpadakis P, Rudolph G, Boergen K P
Аннотация
BACKGROUND: Motility restrictions of the eye muscles represent a common and serious impairment for patients with Grave's orbitopathy. Various surgical approaches have been developed for the rehabilitation of these patients. In this study 64 patients in which only one of the rectus inferior muscles was recessed are presented.
METHOD: The recession was performed using drop anaesthesia. The active cooperation of the patients was necessary for adjustment of the dosage so that undercorrections or more important overcorrections could be prevented. Indications for this recession were a constant diplopia, an abnormal head posture, a pseudoretraction of the upper eyelid or corneal scarring complications.
RESULTS: In all patients the squint angle was significantly reduced. A statistical mathematical correlation between the intraoperatively chosen recession length and the reduction of squint angle was found. On the other hand, the variance of the effect of the operation was so large that no dosage recommendations could be made. This operation technique seems to be able to avoid overcorrections (9.3%) for the majority of patients and only a small group of them presented diplopia postoperatively (10.9%).
CONCLUSIONS: These results show a good functional rehabilitation of our patients. Performing the operation under drop anaesthesia, while taking into account the motility situation, seems to be a good method in order to manage the dosage problems presenting in this clinical entity.
METHOD: The recession was performed using drop anaesthesia. The active cooperation of the patients was necessary for adjustment of the dosage so that undercorrections or more important overcorrections could be prevented. Indications for this recession were a constant diplopia, an abnormal head posture, a pseudoretraction of the upper eyelid or corneal scarring complications.
RESULTS: In all patients the squint angle was significantly reduced. A statistical mathematical correlation between the intraoperatively chosen recession length and the reduction of squint angle was found. On the other hand, the variance of the effect of the operation was so large that no dosage recommendations could be made. This operation technique seems to be able to avoid overcorrections (9.3%) for the majority of patients and only a small group of them presented diplopia postoperatively (10.9%).
CONCLUSIONS: These results show a good functional rehabilitation of our patients. Performing the operation under drop anaesthesia, while taking into account the motility situation, seems to be a good method in order to manage the dosage problems presenting in this clinical entity.