Analysis of Movement Disorders Surgeries at the Department of Ophthalmology,
the FNKV Hospital, Prague, Czech Republic, during the Ten-Years Period
Krásný J., Brunnerová R., Syslová J., Ciprychová J.*, Čeledová J.*, Modlingerová E.*
Oční klinika FN Královské Vinohrady, Praha přednosta prof. MUDr. P. Kuchynka, CSc.*Ortoptistky pracující v průběhu desetiletého období na Oční klinice FNKV, Praha |
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Summary:
The authors analyzed medical records of 1644 surgeries of strabismus and ptosis
performed during the ten-years period (1997–2006). The surgeries were divided
into three groups according to the age of the patients: 531 surgeries were
performed in patients until the age of 6 years, 508 surgeries were in children
aged 7–18 years, and the study included also 605 operative procedures in adult
patients aged 19 years and older. The strabismus operations formed 1401 single
or multi-phases surgeries and the ptosis correction was performed in 243 patients.
The most common surgical procedures in strabismus were weakening or
strengthening procedures on the horizontal muscles (65 %). Out of the weakening
procedures, the authors positively preferred the adjustable partial myotomy
acc. Gonin-Hollwich, which formed 51 % of surgeries on horizontal muscles.
The very favorable results underlined the importance of this type of surgery
in congenital esotropia, Duane syndrome I., and in excess of divergence. This
surgical technique was also used as a weakening procedure as a part of the Kestenbaum
procedure in the treatment of torticollis in horizontal nystagmus.
The solely surgery on oblique or vertical muscles was performed in 16 %, and
the most common operative procedure was the retro-position of the lower oblique
muscle acc. to Parkes, and on the second place, there was its partial myotomy
with electro-cautery acc. to Romer-Martinez. The weakening procedures
were used together on the horizontal and oblique muscles in 10 %. Different surgical
procedures, including the transposition’s ones, were indicated in external
ocular muscles palsies and torticollis. Altogether they formed 12 % of all strabismus
surgeries. The most common procedure to treat the ptosis in children
and teenagers was the fronto-tarsal suspension acc. to Fox (51 %), and in adults,
it was the tarso-resection of the upper eyelid acc. to Fasanella (74 %).
Key words:
strabismus surgery, surgery for ptosis, partial myotomy acc. to Gonin-
Hollwich
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