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Horizontal effect of the surgical weakening of the oblique muscles
Souza-Dias, Carlos;
Arquivos Brasileiros de Oftalmologia , 2011, DOI: 10.1590/S0004-27492011000300007
Abstract: purpose: to evaluate the influence of the oblique muscles surgical weakening on the horizontal alignment in the primary position (pp) and its efficacy on the correction of the "a" and "v" anisotropies. methods: in order to study the influence of bilateral superior oblique muscles (so) weakening on the horizontal alignment in pp, we analyzed the files of 12 patients who underwent only that operation; no other muscle was operated on. we took the opportunity of those 12 patients to analyze the effect of their operation on the correction of "a" incomitance. for evaluating the effect of the inferior oblique muscles (io) weakening on the correction of the "v" pattern, we analyzed retrospectively the files of 67 anisotropic patients who underwent a bilateral so weakening. in 10 of them, the only operation was the oblique muscles weakening and, in 57 patients, the horizontal recti were also operated on for the horizontal deviations in primary position. these patients were divided into two groups: 50 were esotropic and 17 exotropic. there was not any mixed anisotropy. results: the mean value of the preoperative "v" incomitance of the 50 esotropic patients was 24.25? ± 10.15?; the mean postoperative correction was 15.56 ? ± 8.74?. the mean correction between the pp and upgaze was 7.52? ± 7.47? and from the pp to downgaze was 8.56? ± 9.21?. the same values of the 17 exotropic patients was: preoperative 31.88? ± 9.4?; primary position to upgaze was 13.11? ± 4.9? and primary position to downgaze 14.11? ± 12.48?. the mean preoperative value of the "a" incomitance among the 12 patients who underwent isolated so weakening was 30.50? ± 19.25? and the postoperative was of 9,92?, therefore a mean correction of 22.58? ± 17.54?. among these ones, in 5 there was no alteration of the deviation in primary position, in 4 there was an exo-effect and in 3 there was an eso-effect. the mean alteration of the deviation in pp was an exo-shift of 2.25?. conclusions: 1) there was no difference in t
Iraj Ahadzadegan
Acta Medica Iranica , 1994,
Abstract: This article presents a new technique for weakening the superior oblique muscle by lengthening it's tendon. Lengthening is accomplished by a nasal superior oblique tenotomy, and by inserting a segment of silicone band 240 between the cut ends of the tendon."nThis technique is useful for the treatment of Brown syndrome and cases with superior oblique overaction.
Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?  [PDF]
Hande Taylan Sekeroglu,Ozlem Dikmetas,Ali Sefik Sanac,Emin Cumhur Sener,Umut Arslan
Journal of Ophthalmology , 2012, DOI: 10.1155/2012/813085
Abstract: Objective. To evaluate and quantify the effect of inferior oblique muscle weakening on horizontal deviations. Methods. The medical files of patients who had undergone an inferior oblique weakening as a single procedure were all reviewed. The main measures were the type of inferior oblique overaction (IOOA), pre- and postoperative amount of IOOA, and horizontal deviations in primary position. Results. The study was conducted with 66 patients (30 males, 36 females). The median age was 11 years (1–49). Of the 66 patients, 30 (45.5%) had primary and 36 (54.5%) had secondary IOOA. The most common procedure was inferior oblique anteriorization in 32 patients (48.5%). The mean postoperative horizontal and vertical deviations and the amount of IOOA were decreased postoperatively ( for all). The median amount of correction of horizontal near and distance deviations was (0–20). The preoperative amount of IOOA, the presence of fourth nerve palsy, and the type of the weakening procedure had no significant effect on the amount of correction of horizontal deviations. Conclusion. The inferior oblique weakening procedures have secondary effects and warrant reduction of horizontal deviations in varying degrees. This should be borne in mind in planning a simultaneous horizontal muscle surgery and setting the surgical amount. 1. Introduction Inferior oblique muscle overaction (IOOA) may be primary or secondary. The former occurs in 72% of congenital esotropia, 34% of accommodative esotropia, and 32% of intermittent exotropia [1]. The most common cause of secondary IOOA is fourth nerve palsy. A variety of procedures have been performed including recession, hang-back recession, myotomy, myectomy, anterior transposition, nasal transposition, denervation, and muscle fixation [2–7]. However, these surgeries may have effect not only on vertical deviations but also on horizontal deviations in varying degrees. There is a knowledge that the weakening of the inferior oblique muscles causes an esodeviation about 5–10?PD, and the weakening of the superior oblique muscles causes an esodeviation about 10–15?PD [8]. There are a number of previous studies that were designed to provide comparative data on inferior oblique muscle weakening surgeries’ effects on vertical deviations [4, 7, 9–11]. According to this data, there is a possibility that inferior oblique weakening may affect by itself horizontal alignment in primary position, may influence plans and numbers of horizontal muscle surgeries, and furthermore it may be enough in a particular amount of deviations to provide horizontal
Inferior oblique inclusion, Incidence Early detection and Prevention
Mahmoud M Saleh
Egyptian Journal of Hospital Medicine , 2010,
Abstract: Purpose: To evaluate the incidence of inferior oblique inclusion during hooking of the lateral rectus muscle and how to detect and prevent. Methods : 50 patients (80) eyes operated upon lateral rectus muscles(recession 55 eyes resection 25 eyes ) for correction of horizontal deviation (esotropia and exotropia) the incidence of inferior oblique inclusion during hooking of the lateral rectus muscle throw fornix conjunctival incision was evaluated and managed. Results: the incidence of inferior oblique inclusion was found in 17 eyes 21.25%(12 eyes 15% Partial inclusion and 5 eyes 6.25% total inclusion) the inclusion was detected and managed early. Post operatively no element of vertical deviation due to inferior oblique inclusion. Conclusion: inferior oblique inclusion is a preventable complication if taken in consideration during hooking of the lateral rectus muscle.
Anterior plagiocephaly with contralateral superior oblique overaction  [cached]
Jethani Jitendra,Dagar Abhishek,Vijayalakshmi P,Sundaresh K
Indian Journal of Ophthalmology , 2008,
Abstract: Anterior plagiocephaly is a craniofacial anomaly related to premature unilateral synostosis. We present three cases of anterior plagiocephaly with contralateral superior oblique dysfunction. A detailed ophthalmic examination, including orthoptic assessment for the extraocular muscle misalignment, with appropriate radio-imaging was done in all the three cases. All of them showed a right-sided plagiocephaly, with overaction of the left superior oblique muscle, alternating exotropia and a dissociated vertical deviation. Two underwent surgical correction of squint. Both were well aligned after squint surgery. Plagiocephaly has been reported to simulate superior oblique muscle paresis. We report a rare occurrence of contralateral superior oblique muscle overaction in three children with anterior plagiocephaly.
On Paraconsistent Weakening of Intuitionistic Negation  [PDF]
Zoran Majkic
Computer Science , 2011,
Abstract: In [1], systems of weakening of intuitionistic negation logic called Z_n and CZ_n were developed in the spirit of da Costa's approach(c.f. [2]) by preserving, differently from da Costa, its fundamental properties: antitonicity, inversion and additivity for distributive lattices. However, according to [3], those systems turned out to be not paraconsistent but extensions of intuitionistic logic. Taking into account of this result, we shall here make some observations on the modified systems of Z_n and CZ_n, that are paraconsistent as well.
Abelian threshold models and forced weakening  [PDF]
Eric F. Preston,Jorge S. Sá Martins,John B. Rundle
Physics , 2001,
Abstract: Mean field slider block models have provided an important entry point for understanding the behavior of discrete driven threshold systems. We present a method of constructing these models with an arbitrary frictional weakening function. This `forced weakening' method unifies several existing approaches, and multiplies the range of possible weakening laws. Forced weakening also results in Abelian rupture propagation, so that an avalanche size depends only on the initial stress distribution. We demonstrate how this may be used to accurately predict the long-time event statistics of a simulation.
Inferior Oblique Muscle Weakening: Is It Possible to Quantify Its Effects on Horizontal Deviations?  [PDF]
Hande Taylan Sekeroglu,Ozlem Dikmetas,Ali Sefik Sanac,Emin Cumhur Sener
Journal of Ophthalmology , 2012, DOI: 10.1155/2012/813085
A New Anatomical and Surgical Landmark in Internal Abdominal Oblique Muscle Fat Triangle
Kazem Madaen,Behrooz Niknafs
Urology Journal , 2012,
Abstract: Purpose: To determine the anatomical landmark within the internal oblique muscle. Materials and Methods: In a prospective study, the abdominal wall was examined for internal oblique muscle land marks in 900 patients undergoing laparatomy. Results: There was a fat line at anterior superior iliac spine level to access the underlying layers and then to the abdominal cavity. Conclusion: A fat triangle within the internal oblique muscle provides a suitable region of surgical incision at the lower part of the abdominal wall.
An Anatomical Study of the Inferior Oblique Muscle with Emphasis on Its Nerve Entry  [PDF]
Vishal Kumar,B.V. Murlimanju,P. Devika,Narga Nair
Chang Gung Medical Journal , 2011,
Abstract: Background: Anatomical studies regarding the inferior oblique muscle are scarce and theexact location of the entry of oculomotor nerve to the muscle has not beenreported. In the present study, the objectives were to examine the exact location of the entry of oculomotor nerve to the inferior oblique muscle and tostudy the topographical anatomy of the muscle.Methods: The study included 56 intact orbits from 28 embalmed south Indian adultcadavers. The entire course of the nerve to the inferior oblique was exposedfrom both anterior and posterior aspects in all specimens. The exact locationof the entry of nerve supplying the inferior oblique muscle was identified andthe distances of the muscle from inferior and medial orbital margins weremeasured.Results: The oculomotor nerve entered the inferior oblique muscle through the orbitalsurface in 42 (75%) cases, through the ocular surface in 10 (17.9%) casesand through the posterior border in 4 (7.1%) cases. The distance of the muscle from the inferior orbital margin was 1 mm in majority (78.5%) of thecases. The distance of the muscle from the medial orbital margin was 11 mmin majority (42.8%) of the cases.Conclusion: The present study reports that the oculomotor nerve most often enters theinferior oblique muscle through its orbital surface. Detailed knowledge of thetopographical anatomy of inferior oblique muscle and its site of nerve entryare essential for surgeons when performing ophthalmological surgery andregional anesthesia.
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