Special Forms Of Strabismus

Objective: To explore the diagnosis and surgery effects of several specialforms of strabismus. Methods: ① Use Hummelsheim procedure and weakening of direct antagonist ofthe absent rectus or inferior oblique to treat congenital absence ofrecti.② Use marginal myotomy to treat the eye with minimal overaction of inferior oblique, and use myectomy to treat the other one with significant overaction of inferior oblique in 3 cases of special forms of asymmetric superior oblique palsy.③ Based on both oblique functions and magnitude of the patterns, 59 cases of V pattern were divided into three groups and treated with three surgical methods, vertical transposition of horizontal recti, inferior oblique weakness and vertical transposition of horizontal recti combined with inferior oblique weakness. The deviation angle and visual function were examined before and after the operation.Result:① After operation, the deviation angles of 3 cases with congenital absentrecti were significantly reduced. Vertical deviation were completely corrected in cases Hummelsheim procedure were carried out combined with weakening of direct antagonist of absent rectus, while deviation angle was largely decreased in patient combined with inferior oblique weakening. No anterior segment ischemia syndrome occurred in all 3 patients .(2) After operation, 3 cases with special forms of asymmetric superior oblique palsy had normal eye position, their compensatory head tilts disappeared, and the two eye movements were harmonious.(3) The deviation angle in primary position and 25° up and down gazes of 59 V-patterns were significantly improved, and V-pattern vanished. 20 cases had stereo vision before operation and 46 cases had stereopsis after operation.Conclusion:? Hummelsheim procedure is effective in treatment of congenital absence of recti. Preservation of anterior ciliary vessels during operation could avoid the occurrence of anterior segment ischemic syndrome.(2) Marginal myotomy produced stable effect in treatment of special forms of asymmetric superior oblique palsy, keeping the patients from second operation.(3) Three surgical methods were used to treat V-patterns, according to theinferior oblique function and magnitude of patterns. Three surgical procedures in our study were effective.