Maximum motor fusion test in determining the target angle for surgical treatment of esotropia

G. Dimitrova; B. Mihaylova

doi:10.14748/bro.v0i3.4549

Maximum motor fusion test in determining the target angle for surgical treatment of esotropia

G. Dimitrova, B. Mihaylova

Abstract

The greatest challenge for successfu1 treatment of esotropia is determining the target angle of deviation (the angle to bе operated on). Lots of factors have influence on the surgical decision - age, refraction error, accommodation/convergence ratio (angle of deviation for distance, near, with and without glasses). Aim of this study is to analyze the role of maximum motor fusion test (ММFТ) in planning the amount of surgery for the best outcome of esotropia treatment. Materials and methods: 200 patients with alternating/altenated esotropia were operated for the period of 2000-2014. Bilateral medial rectus muscle recessions were performed in 170 patients (З40 eyes). ЗО patients underwent unilateral large recession of medial rectus muscle. Diagnostic, surgical and statistical methods were used. Results: MMFT was done in 77.4% patients. They had significantly better alignment for distant and near as compared to those, whose surgery was planned only according to alternating prism cover test. Conclusion: The MMFT is a reliable test to insure enhanced surgery with decrease of residual angle and without risk of surgical overcorrection.

Keywords

test of maximum motor fusion; large bimedial recessions; residual angle; surgical overcorrection; enhanced surgery

Full Text

References

Mims JL 3rd, Wood RC. The maximum motorfusion test: a parameter for surgery for acquired esotropia. J AAPOS, 2000 Aug; (4):211-6.

Mims JL, Treff G, Kincaid M, et al. Quantitative surgical guidelines for bimedial recession for infantile esotropia. Binocular Vis Strabismus Q 1985; 1:7-22.

Berard PV: The use of prisms in the pre- and postoperative treatment of deviation in concomitant squint. In Fells P, editor: The first congress of the International Strabismological Association, Acapulco, Mexico, 1970, London 1971, Henry Kimpton; 227-34.

Aust W, Welge-Lussen L: Preoperative and postoperative changes in the angle of squint following long-term preoperative prismatic compensation. In Fells P, editor: ThefirstcongressoftheInternational Strabismological Association, Acapulco, Mexico, 1970, London 1971, Henry Kimpton; 217-26.

Welge-Lussen L, Aust W: Changes in the angle of squint after prismatic correction: postoperative follow-upresults. In Disorders of ocular motility: neurophysiological and clinical aspects, Symposium der Deutschen Ophthalmologischen Gessellschaft 1977; 341-6.

Scott WE, Thalacker JA: Preoperative prism adaptation in acquired esotropia. Ophthalmologica 1984; 189:49-53.

Jampolsky A: A simplified approach to strabismus diagnosis. In: Symposium on Strabismus, St Louis, CV Mosby Co 1971; 34-92.

Prism Adaptation Study Research Group: Efficacy of prism adaptation in the surgica lmanagement of acquired esotropia. Arch Ophthalmol 1990;108:1248-56.

Kutschke PJ, Scott WE, Steward SA: Prism adaptation for esotropia with a distanceneardisparity. J Pediatr Ophthalmol Strabismus 1992; 29:12.

Kutschke PJ, Keech RV: Surgical outcome after prism adaptation for esotropia with a distance-neardisparity. J AAPOS 2001 Jun; 5(3):189-92.

Repka MX, Connett JE, Scott WE; Prism Adaptation Study Research Group: The one year surgical outcome after prism adaptation for the management of acquired esotropia. Ophthalmol 1996; 103:992-8.

Hwang JM, Min BM, Parks SC, Sung NK: A randomized comparison of prism adaptation and augmented surgery in the surgical management of esotropia associated with hypermetropia: one year surgical outcomes. J AAPOS 2001 Feb; 5(1):31-4.

Jaffe T, Trotter J, Watts P, Kraft SP, Abdoller M: Preoperative prism adaptation in acquired esotropia with convergence excess. J AAPOS 2003 Feb; 7(1):28-33.

Deliste P, Strasfeld M, Pelletier D: The prism adaptation test inoperative evaluation of esodeviation. Can J Ophthalmol 1988; 23:208-12.

Veronneau-Troutman S: Prisms in the medical and surgical management of strabismus. Mosby-YearBook, Inc 1994; 103.

Dalman NE, Velez G, Thacker N, Britt MT, Velez FG: Maximum motor fusion combined with one-hour preoperative prism adaptation test in patients with acquired esotropia. J AAPOS 2006; 10:561-4.

DOI: http://dx.doi.org/10.14748/bro.v0i3.4549