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An Eye on the Arts – the Arts on the Eye
404
Li et al
Volume 20 Number 5 / October 2016
rectus resection followed by standard transposition could correct small horizontal deviation and strengthen the effect of standard transposition on the ocular alignment and movement. We did not measure the subjective torsion in these patients. No patient complained of objective torsional diplopia after surgery. In conclusion, forced duction testing is crucial for classification and treatment of patients with DEP. The surgical procedures should be individualized based on the etiology and the evaluation of ocular motility and vertical/horizontal deviation in the primary position. Modified Knapp procedure and modified Knapp procedure augmented by Foster suture or rectus muscle resection were reasonably effective in the treatment of nonrestrictive DEP with hypotropia of #35D. All can obviously improve upgaze without noticeable limitation of downgaze, which is good to obtain the binocular single vision in the primary and reading position. For the greater deviation of 30D-40D, Foster suture or rectus resection should be added. The Foster transposition has the most powerful effect on improving upgaze. References 1. vonNoorden GK, Campos EC. Binocular Vision and Ocular Motility: theory and management of strabismus. St. Louis: C.V. Mosby Company; 2002:443-51. 2. Jampel RS, Fells P. Monocular elevation paresis caused by a central nervous system lesion. Arch Ophthalmol 1968;80:45-57. 3. Scott WE, Jackson OB. Double elevator palsy: the significance of inferior rectus restriction. Am Orthopt J 1977;27:5-10. 4. Metz HS. Double elevator palsy. Arch Ophthalmol 1979;97:901-3. 5. Bagheri A, Sahebghalam R, Abrishami M. Double elevator palsy, subtypes and outcomes of surgery. J Ophthalmic Vis Res 2008;3:108-13.
6. Rosenbam AL, Santiago AP. Clinical strabismus management: Principles and Surgical Techniques. Philadelphia: WB Saunders Company; 1999:272-83. 7. Knapp P. The surgical treatment of double elevator paralysis. Trans Am Ophthalmol Soc 1969;67:304-23. 8. Cooper EL, Greenspan J. Operation for double elevator palsy. J Pediatr Ophthalmol Strabismus 1971;8:8-14. 9. Barsoum-Homsy M. Congenital double elevator palsy. J Pediatr Ophthalmol Strabismus 1983;20:185-91. 10. Lee JP, Collin JRO, Timms C. Elevating the hypotropic globe. Br J Ophthalmol 1986;70:26-32. 11. Kocak-Altintas AG, Kocak-Midillioglu I, Dabil H, et al. Selective management of double elevator palsy by either inferior rectus recession and/or knapp type transposition surgery. Binocul Vis Strabismus Q 2000;15:39-46. 12. Burke JP, Ruben JB, Scott EW. Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability. Br J Ophthalmol 1992;76:734-7. 13. Foster RS. Vertical muscle transposition augmented with lateral fixation. J AAPOS 1997;1:20-30. 14. Rosenbaum AL. Costenbader Lecture. The efficacy of rectus muscle transposition surgery in esotropic Duane syndrome and VI nerve palsy. J AAPOS 2004;8:409-19. 15. Gunton KB. Vertical rectus transpositions in sixth nerve palsies. Curr Opin Ophthalmol 2015;26:366-70. 16. Rattigan S, Nischal KK. Foster-Type Modification of the Knapp Procedure for Anomalous Superior Rectus Muscles in Syndromic Craniosynostoses. J AAPOS 2003;7:279-82. 17. Hong S, Chang YH, Han SH. Full Tendon Transposition Augmented with Posterior Intermuscular Suture and RecessionResection Surgery. Korean J Ophthalmol 2006;20(4):254-5. 18. Kamlesh, Dadeya S. Surgical management of unilateral elevator deficiency associated with horizontal deviation using a modified Knapp’s procedure. Ophthalmic Surg Lasers Imaging 2003;34(3):230-35. 19. Coat DK, Olitsky SE. Strabismus Surgery and Its Complications. New York: Springer; 2007:124-9.
An Eye on the Arts – the Arts on the Eye
. and each conversation made Jack more curious about his son’s surroundings. “It’s awesome, Dad.” “What does it look like?” “You don’t see things.You’re inside them.” “What do you mean?” “Like my childhood . I see it . So cool!” Mitch Albom, The First Phone Call from Heaven (New York: Harper Collins Publishers, 2013), 33.
Journal of AAPOS
Li et al
Volume 20 Number 5 / October 2016
rectus resection followed by standard transposition could correct small horizontal deviation and strengthen the effect of standard transposition on the ocular alignment and movement. We did not measure the subjective torsion in these patients. No patient complained of objective torsional diplopia after surgery. In conclusion, forced duction testing is crucial for classification and treatment of patients with DEP. The surgical procedures should be individualized based on the etiology and the evaluation of ocular motility and vertical/horizontal deviation in the primary position. Modified Knapp procedure and modified Knapp procedure augmented by Foster suture or rectus muscle resection were reasonably effective in the treatment of nonrestrictive DEP with hypotropia of #35D. All can obviously improve upgaze without noticeable limitation of downgaze, which is good to obtain the binocular single vision in the primary and reading position. For the greater deviation of 30D-40D, Foster suture or rectus resection should be added. The Foster transposition has the most powerful effect on improving upgaze. References 1. vonNoorden GK, Campos EC. Binocular Vision and Ocular Motility: theory and management of strabismus. St. Louis: C.V. Mosby Company; 2002:443-51. 2. Jampel RS, Fells P. Monocular elevation paresis caused by a central nervous system lesion. Arch Ophthalmol 1968;80:45-57. 3. Scott WE, Jackson OB. Double elevator palsy: the significance of inferior rectus restriction. Am Orthopt J 1977;27:5-10. 4. Metz HS. Double elevator palsy. Arch Ophthalmol 1979;97:901-3. 5. Bagheri A, Sahebghalam R, Abrishami M. Double elevator palsy, subtypes and outcomes of surgery. J Ophthalmic Vis Res 2008;3:108-13.
6. Rosenbam AL, Santiago AP. Clinical strabismus management: Principles and Surgical Techniques. Philadelphia: WB Saunders Company; 1999:272-83. 7. Knapp P. The surgical treatment of double elevator paralysis. Trans Am Ophthalmol Soc 1969;67:304-23. 8. Cooper EL, Greenspan J. Operation for double elevator palsy. J Pediatr Ophthalmol Strabismus 1971;8:8-14. 9. Barsoum-Homsy M. Congenital double elevator palsy. J Pediatr Ophthalmol Strabismus 1983;20:185-91. 10. Lee JP, Collin JRO, Timms C. Elevating the hypotropic globe. Br J Ophthalmol 1986;70:26-32. 11. Kocak-Altintas AG, Kocak-Midillioglu I, Dabil H, et al. Selective management of double elevator palsy by either inferior rectus recession and/or knapp type transposition surgery. Binocul Vis Strabismus Q 2000;15:39-46. 12. Burke JP, Ruben JB, Scott EW. Vertical transposition of the horizontal recti (Knapp procedure) for the treatment of double elevator palsy: effectiveness and long-term stability. Br J Ophthalmol 1992;76:734-7. 13. Foster RS. Vertical muscle transposition augmented with lateral fixation. J AAPOS 1997;1:20-30. 14. Rosenbaum AL. Costenbader Lecture. The efficacy of rectus muscle transposition surgery in esotropic Duane syndrome and VI nerve palsy. J AAPOS 2004;8:409-19. 15. Gunton KB. Vertical rectus transpositions in sixth nerve palsies. Curr Opin Ophthalmol 2015;26:366-70. 16. Rattigan S, Nischal KK. Foster-Type Modification of the Knapp Procedure for Anomalous Superior Rectus Muscles in Syndromic Craniosynostoses. J AAPOS 2003;7:279-82. 17. Hong S, Chang YH, Han SH. Full Tendon Transposition Augmented with Posterior Intermuscular Suture and RecessionResection Surgery. Korean J Ophthalmol 2006;20(4):254-5. 18. Kamlesh, Dadeya S. Surgical management of unilateral elevator deficiency associated with horizontal deviation using a modified Knapp’s procedure. Ophthalmic Surg Lasers Imaging 2003;34(3):230-35. 19. Coat DK, Olitsky SE. Strabismus Surgery and Its Complications. New York: Springer; 2007:124-9.
An Eye on the Arts – the Arts on the Eye
. and each conversation made Jack more curious about his son’s surroundings. “It’s awesome, Dad.” “What does it look like?” “You don’t see things.You’re inside them.” “What do you mean?” “Like my childhood . I see it . So cool!” Mitch Albom, The First Phone Call from Heaven (New York: Harper Collins Publishers, 2013), 33.
Journal of AAPOS