Journal article
The use of titanium T-plate as platform for globe alignment in severe paralytic and restrictive strabismus
American journal of ophthalmology, Vol.150(3), pp.404-411.e1
09/2010
DOI: 10.1016/j.ajo.2010.03.029
PMID: 20542486
Abstract
To evaluate the long-term effectiveness of improved ocular alignment using a suture/T-plate anchoring platform system. Retrospective, noncomparative, interventional case series. setting: Institutional. study population: Seven consecutive patients with large angle deviations attributable to paralytic and/or restrictive strabismus managed jointly by orbital and strabismus surgeons. intervention procedure: The T-plate base is anchored to the orbital rim with the shaft projecting toward the orbital apex to simulate the origin of the affected muscle. A nonabsorbable suture serves as the coupling element linking the muscle insertion to the tip of the T-plate such that the suture coincides with the axis of the dysfunctional muscle and yields a pull vector to simulate the passive tensile force of the muscle. Information analyzed included patient demographics, etiology of strabismus and characteristics, prior muscle surgeries, secondary interventions, subjective appraisal of diplopia, and final ocular alignment measurements. main outcome measures: Subjective appraisal of diplopia, final ocular alignment in primary gaze, and late stability. All 7 patients showed marked reduction in ocular deviation with a median change of 33 prism diopters (PD) and a range of 7 to 72 PD. For the 6 patients with medial rectus dysfunction, the final ocular alignment ranged from 6 to 18 PD of residual exotropia in primary gaze. The patient with sixth nerve palsy had 5 PD of residual esotropia. There were no failures after an average of 59.4 months of follow-up. A globe tethering technique using a suture/titanium T-plate anchoring platform system effectively treats refractory cases of paralytic and restrictive strabismus with large angles of deviation.
Details
- Title: Subtitle
- The use of titanium T-plate as platform for globe alignment in severe paralytic and restrictive strabismus
- Creators
- David T Tse - Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 N.W. 17th St., Miami, FL 33136, USA. dtse@med.miami.eduErin M ShriverKenneth B KrantzJeffrey D TseHilda CapoCraig A McKeown
- Resource Type
- Journal article
- Publication Details
- American journal of ophthalmology, Vol.150(3), pp.404-411.e1
- Publisher
- United States
- DOI
- 10.1016/j.ajo.2010.03.029
- PMID
- 20542486
- ISSN
- 0002-9394
- eISSN
- 1879-1891
- Grant note
- Publication of this article was supported by grant no. P30-EY014801 from National Institues of Health, Betheda, Maryland, and by an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York. David T. Tse is the inventor of an integrated orbital tissue expander and the University of Miami holds the rights to the patent. Dr Tse receives royalties from the sale of the device by Innovia. He has received grant support from the Boston Scientific Corp, Small Business Innovation Research (NIH), and the Department of Defense. The authors, their families, employers, and business associates have no financial or proprietary interest in any product or company associated with any device, instrument, or drug mentioned in this article. The authors have not received any payment as consultants, reviewers, or evaluators of any of the devices, expert witness testimony, instruments, or drugs mentioned in this article. There are no financial involvements with companies that directly compete with products in this manuscript. Involved in design and conduct of the study (D.T.T., C.A.M.); data collection (D.T.T., E.M.S., K.B.K., C.A.M.); management (D.T.T., E.M.S., K.B.K., H.C., C.A.M.), analysis (D.T.T., E.M.S., K.B.K., J.D.T., H.C., C.A.M.), and interpretation of the data (D.T.T., E.M.S., K.B.K., J.D.T., H.C., C.A.M.); and preparation (D.T.T., E.M.S., K.B.K.), review (D.T.T., E.M.S., K.B.K., J.D.T., H.C., C.A.M.), and approval of the manuscript (D.T.T., E.M.S., K.B.K., J.D.T., H.C., C.A.M.). All evaluations were conducted with prior approval of the Institutional Review Board for human studies at the University of Miami Miller School of Medicine. William J. Feuer, from the Bascom Palmer Eye Institute Biostatistics Department, provided assistance in statistical analysis. F. Harold Kushner provided follow-up strabismus measurements and photographs on Case 1.
- Language
- English
- Date published
- 09/2010
- Academic Unit
- Otolaryngology; Ophthalmology and Visual Sciences
- Record Identifier
- 9983979983502771
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