E-Book, Englisch, 334 Seiten, ePub
Ludwig Strabismus Surgery
1. Auflage 2021
ISBN: 978-1-63853-474-7
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Innovative and Classic Approaches
E-Book, Englisch, 334 Seiten, ePub
ISBN: 978-1-63853-474-7
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Strabismus correction is the third most common ophthalmic surgery in the US, with 1.2 million procedures performed each year. by renowned pediatric ophthalmologist Irene Ludwig provides comprehensive coverage of strabismus treatment – featuring state-of-the-art techniques based on recent anatomical research and discoveries. Throughout the text and accompanying videos, an impressive group of contributors share clinical pearls and firsthand knowledge.
Recent research shows that strabismus has a mechanical etiology more frequently than previously thought, and that by directly correcting the mechanical defects, more targeted correction is possible than with traditional approaches. Accordingly, the book is organized by mechanism rather than strabismic deviations and patterns. Presented in four parts, each of which is further delineated by sections, this unique textbook includes 36 chapters starting with the fascinating history of strabismus surgery and concluding with future possible treatments.
Key Highlights
- New surgical techniques designed to correct muscle displacements and muscle defects related to abnormalities of the extraocular muscle pulleys and intermuscular bands
- Recognition and repair of stretched scar and flap tear
- A section dedicated to CNS-related causes of strabismus discusses state-of-the-art surgical approaches for conditions including nystagmus and cranial nerve palsies
- A comprehensive summary of injection techniques using botulinum toxin and bupivacaine to correct strabismus, particularly in otherwise inoperable conditions
- Ninety strabismus surgery videos demonstrate a full spectrum of basic to advanced techniques
- Remarkable illustrations beautifully capture the complex anatomy of the eye muscles and pulleys
The mechanistic approaches described in this outstanding resource will help trainees and seasoned ophthalmologists achieve more precise and lasting results.
This book includes complimentary access to a digital copy on https://medone.thieme.com.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
Part I Introduction
1 The History of Strabismus Surgery
Part II Strabismus Diagnosis and Surgical Planning
Section 1 General Preoperative Evaluation
Introduction: Surgical Planning—Gathering Data
2 The History and Examination in Strabismus
3 The Use of Testing, Consultants, and Intraoperative Assessment
Section 2 Surgical Anatomy and Physiology and Surgical Principles
4 Surgical Anatomy of the Extraocular Muscles
5 Collagen and Healing
6 Injection of Eye Muscles to Treat Strabismus
7 Complications of Strabismus Surgery
8 The Inferior Oblique—Strabismus Diagnosis and Surgical Planning: Surgical Anatomy, Surgical Principles, and Wound Healing
Section 3 Torsion and the Oblique Muscles
9 The Superior Oblique
10 Brown's Syndrome
11 Torsion
Section 4 Inflammation and Strabismus
12 Thyroid Ophthalmopathy
13 Presumed Sinus-Related Strabismus
14 Pterygium and Strabismus
Section 5 Strabismus Related to Central Nervous System Disorders
15 Duane's Syndrome
16 Dissociated Vertical Deviations
17 Nystagmus Surgery
18 Cranial Nerve Palsies
Section 6 Orbital and Pulley Abnormalities
19 Displaced Muscles (Pulley Heterotopias)
20 Traumatic Strabismus: Direct Orbital and Muscle Trauma and Flap Tear
Part III Surgical Techniques
Section 1 General Principles and Classic Techniques
21 Anesthesia for Strabismus Surgery
22 Strabismus Surgical Instrumentation
23 Classic Strabismus Surgery: Rectus Muscle
24 Plications and Tucks
Section 2 Oblique Muscle Surgery
25 The Inferior Oblique: Surgical Techniques
26 The Superior Oblique Surgical Techniques
Section 3 Managing Collagen Abnormalities during Strabismus Surgery
27 Stretched Scar Repair and Management of Other Weak Collagen Abnormalities
28 Managing Excessive Scar Tissue (Adhesive Syndrome)
Section 4 Advanced Techniques
29 Traumatic Strabismus Repair (Flap Tear, Slipped and Lost Muscles)
30 Pulley Surgeries
31 Injection Technique
32 Adjustable Sutures and Hang-Back Suture Technique
33 Procedures to Restrict Movement
34 Mini-Procedures and Compartmental Surgery for Small Angle Strabismus
35 Transpositions
Part IV Conclusion
36 Imagining the Future of Strabismus Surgery
Videos
Video 2.1 Animated Distance Fixation Targets.
Video 2.2 Examination Tips and Tricks.
Video 3.1 Torsion Test. Torsional forced duction testing and exaggerated traction testing of the obliques.
Video 5.1 Stretched Scar Appearances. Seven medial and lateral rectus muscles with stretched scars are demonstrated, showing different presentations, including one in which the stretch is not apparent until the muscle is disinserted and viewed from underneath.
Video 5.2 Scar Migration. Lateral rectus scar migration and small scar stretch in 9-year-old with small consecutive esotropia.
Video 5.3 Pulled-in-Two Syndrome (PITS). This 54-year-old woman had consecutive exotropia develop gradually over years, after having undergone bilateral medial rectus (MR) muscle recession as a child for esotropia. During this surgical procedure, bilateral stretched scar repair was being performed. The right MR repair had been performed uneventfully, but during left MR repair, the muscle ruptured in two at the musculotendinous junction, leading to a lost MR muscle. Its retrieval and direct repair are demonstrated in this video. After the surgery, her husband related that she and her family members suffered from other manifestations of collagen weakness with multiple orthopaedic injuries and dysfunction related to joint hypermobility.
Video 5.4 Scar Migration and Rolling of Insertion Due to Excessive Scarring. Patient 2 months after initial repair of large angle exotropia, now with 25 diopters consecutive esotropia. Right lateral rectus muscle had been recessed 9 mm, but upon reoperation, insertion was found migrated posteriorly and rolled backward, due to excessive fibrosis and scar contracture.
Video 10.1 Cadaveric Superior Oblique Tendon.
Video 11.1 Single Red Maddox Rod Test.
Video 12.1 Intraoperative Forced Duction Showing Tight Lateral and Medial Rectus Muscles in Thyroid Ophthalmopathy.
Video 12.2 Forced Duction Testing Repeated after Disinsertion of the Medial Rectus Muscle in Thyroid Ophthalmopathy.
Video 13.1 Presumed Sinus-Related Strabismus. Intraoperative appearance of extraocular muscles and perimuscular tissue in a case of presumed sinus-related strabismus.
Video 14.1 Conjunctival Autograft.
Video 16.1 Dissociated Vertical Deviation Characteristics.
Video 16.2 Asymmetrical Dissociated Vertical Deviation.
Video 16.3 Superior Rectus Hang-Back Recession for Dissociated Vertical Deviation.
Video 19.1 Transconjunctival Identification of Displaced Muscles. Viewing muscle paths through conjunctiva may help identify muscle displacement(s) without or prior to incision.
Video 19.2 Displaced Muscles. Composite video of five cases of muscle displacement.
Video 19.3 Displaced Medial Rectus Muscles and Esotropia. Video of Case 2, Chapter 19 (Section 19.13.2), showing paradoxical exoshift with medial rectus (MR) myopexy sutures to treat bilateral inferior displacement of the MR muscles.
Video 19.4 LR-SR and Deficiency Possibly Related to Forceps Injury at Birth. A 29-year-old woman had undergone multiple prior strabismus surgeries to treat recurring strabismus, which began as early childhood esotropia. Alignment would be corrected for several years, but invariably recur. The last recurrence was precipitated by pregnancy, which is known to weaken collagen. MRI showed nasal displacement of the superior rectus muscles, and inferior displacement of the lateral rectus muscles, which was corrected surgically with pulley sleeve fusion as shown in this video. This defect may have been related to forceps injury at birth, which is shown in photos.
Video 20.1 Normal Inferior and Medial Rectus Muscles. Composite of several normal inferior rectus muscles, showing reflection of capsule away from muscle, toward the Desmarres retractor. Medial rectus muscles, showing intact capsule to insertion. Full ciliary vasculature and lack of dragging of external tissues are other normal landmarks.
Video 20.2 Flap Tear Appearances. Composite showing different appearances of various types of inferior and medial rectus muscle flap tears in seven cases.
Video 20.3 Correction of 70-Diopter Exotropia with Flap Tear Repair Alone (Sort Of). Video of case 4, which is a repair of bilateral lamellar medial rectus flaps and small right inferior rectus muscle flap, combined with 9-mm recession of the right lateral rectus muscle, resulted in 25 diopters esotropia. This required later lateral rectus muscle advancement, which is seen in Video 5.4.
Video 20.4 Traumatic Inferior Oblique Transection. Video of Case 6, with inferior oblique transection due to blunt trauma.
Video 21.1 A Local Anesthetic Technique for Strabismus Surgery.
Video 23.1 Medial Rectus Muscle Recession. With fornix incision, using Parks’ techniques.
Video 23.2 Lateral Rectus Muscle Recession. With fornix incision, using Parks’ techniques.
Video 23.3 Medial Rectus Muscle Resection. With fornix incision, using Parks’ techniques.
Video 23.4 Lateral Rectus Muscle Resection. With fornix incision, using Parks’ techniques.
Video 24.1 A Surgeon‘s View of a Plication of the Right Lateral Rectus through a Fornix Incision.
Video 25.1 Inferior Oblique Recession.
Video 25.2 Anterior Transposition of the Inferior Oblique.
Video 25.3 Combined Resection and Anterior Transposition of the Inferior Oblique.
Video 25.4 Nasal Myectomy of the Inferior Oblique. Nasal myectomy—left inferior oblique—surgeon’s view.
Video 26.1 Bilateral Full Tendon Advancement of the Superior Obliques.
Video 26.2 Bilateral Full Tendon Advancement of the Superior Obliques with Anomalous Insertions.
Video 26.3 Harada-Ito Procedure Right Superior Oblique.
Video 26.4 Anterior Superior Oblique Plication. To correct excylcotorsion.
Video 26.5 Left Superior Oblique Hang-Back Recession.
Video 26.6 Superior Oblique Mini-Tenotomies. To correct incyclotorsion.
Video 27.1 Stretched Scar 1. Bilateral medial rectus muscle stretched scar repair in a 39-year-old man with 40 diopters consecutive exotropia after childhood esotropia repair.
Video 27.2 Stretched Scar 2. Bilateral medial rectus muscle stretched scar repair in an 8-year-old girl with consecutive exotropia.
Video 27.3 Stretched Scar with Flip-Over. Left medial rectus stretched scar repair in a 9-year-old. Identification of scar stretch required disinsertion of muscle and inspection of underside.
Video 27.4 Lateral Rectus Stretched Scar. Lateral rectus stretched scar in a 19-year-old with consecutive esotropia. Repair using 6–0 clear polypropylene.
Video 28.1 Scar and Conjunctival Recession. Scar tissue and conjunctival recession to correct small angle esodeviation in a 58-year-old man who fell face first from a roof, with the only finding at surgery being nasal perimuscular fibrosis surrounding the left medial rectus muscle.
Video 28.2 Debulking of Scar Tissue from Conjunctiva with Conjunctival Recession and Amniotic Membrane Graft.
Video 28.3 Amniotic Membrane Graft. Amniotic membrane grafting in restrictive strabismus.
Video 29.1 Flap Tear Right Inferior Rectus Muscle (IR), Comparison to Normal Left Inferior Rectus Muscle. Right IR and medial rectus (MR) muscle tears in an 8-year-old girl who presented with exotropia and convergence insufficiency, which evolved over 3 years to exotropia with right hypertropia. Comparison to normal left IR and MR muscles is demonstrated.
Video 29.2 Left Inferior Rectus Muscle (IR) Flap Tear Causing Left Hypertropia, Comparison to...
