RESUMEN
PurposeRetrospective noncomparative case series to investigate the role of rectus muscle myectomy for the treatment of large-angle strabismus in patients with Graves' ophthalmopathy.Patients and methodsData from 47 consecutive patients with Graves' ophthalmopathy who underwent complete myectomy for large-angle strabismus (strabismus greater than 25 prism diopters (PDs)) were collected retrospectively. Pre- and postoperative deviations in primary and reading position were measured in PDs. Postoperative deviation of <5 diopters in primary gaze and functional binocular vision in central 30° field were considered as successful surgical outcomes.ResultsPatients undergoing complete myectomy of the restricted muscles in large-angle strabismus achieved a 78.7% success rate after the first surgery. Reoperation performed on seven patients resulted in 85.7% success rate in reoperation group. The overall success rate was 91.5%. The mean efficacy of the isolated rectus muscle myectomy was 34.3±7.7 PDs.ConclusionsThe complete rectus muscle myectomy technique is effective and predictable in the treatment of large-angle strabismus in patients with Graves' ophthalmopathy.
Asunto(s)
Movimientos Oculares/fisiología , Oftalmopatía de Graves/complicaciones , Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Estrabismo/cirugía , Visión Binocular/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Oftalmopatía de Graves/diagnóstico , Oftalmopatía de Graves/fisiopatología , Oftalmopatía de Graves/cirugía , Humanos , Masculino , Persona de Mediana Edad , Músculos Oculomotores/diagnóstico por imagen , Músculos Oculomotores/fisiopatología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estrabismo/etiología , Estrabismo/fisiopatología , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: Quantitative analysis can be used in combination with fluorescence microscopy. Although the human eye is able to obtain good qualitative results, when analyzing the spatial organization of telomeres in interphase nuclei, there is a need for quantitative results based on image analysis. METHODS: We developed a tool for analyzing three-dimensional images of telomeres stained by fluorescence in situ hybridization in interphase nuclei with DNA counterstained with 4',6-diamidino-2-phenylindole. After deconvolution of the image, we segmented individual telomeres. From the location of the telomeres we derived a distribution parameter rhoT, which indicated whether the telomeres were in a disk (rhoT >> 1) or not (rhoT approximately 1). We sorted mouse lymphocyte nuclei and measured rhoT. We also performed a bromodeoxyuridine synchronous cell sorting experiment on live cells and measured rhoT at several instances. RESULTS: Measuring rhoT for nuclei in G0/G1, S, and G2 produced 1.4 +/- 0.1, 1.5 +/- 0.2, and 14 +/- 2, respectively, showing a significant difference between G2 and G0/G1 or S. For the bromodeoxyuridine synchronous cell sorting experiment, we found a cell cycle dependency of rhoT and a correlation between rhoT and an observer. CONCLUSIONS: In this study we present a quantitative method to characterize the organization of telomeres using three-dimensional imaging, image processing, and image analysis.