Usefulness of a New Device for Measurement of Cyclodeviation in Strabismus Surgery

DOI 2 References Open Access
  • Sasaki Kakeru
    Department of Ophthalmology, Teikyo University School of Medicine,
  • Hayashi Takao
    Department of Ophthalmology, Teikyo University School of Medicine, Department of Orthoptics, Faculty of Medical Technology, Teikyo University
  • Kaneko Hiroyuki
    Department of Ophthalmology, Teikyo University School of Medicine, Department of Orthoptics, Faculty of Medical Technology, Teikyo University
  • Nakagawa Maki
    Department of Ophthalmology, Teikyo University School of Medicine,
  • Usui Chie
    Department of Ophthalmology, Teikyo University School of Medicine,

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  • 斜視手術中の回旋偏位測定の試み

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[Purpose] We developed an instrument for quantitative assessment of cyclodeviation during strabismus surgery. We evaluated and reported the usefulness of this instrument.<br>[Subjects and Methods] 1. Twenty visually normal subjects and twenty patients with cyclotropia were enrolled. Cyclodeviation was measured by a major amblyoscope in a seated position and by this new instrument in both seated and supine positions. The measurements were compared.<br>2. In a patient with binocular superior oblique palsy and subjective cyclodeviation, the amount of cyclodeviation was measured before, during, and after strabismus surgery by the new instrument and the measurements were compared to those by the major amblyoscope.<br>[Results] 1. In the normal subjects, cyclodeviation（mean ± SD）by the major amblyoscope was Ex0.1° ± 0.3°. By the new instrument, the measurements in the seated and supine positions were both Ex0.1° ± 0.2°. In the 20 patients with cyclotropia, cyclodeviation by the major amblyoscope was Ex7.9° ± 4.6°. The measurements in the seated and supine positions by the new instrument were Ex8.1° ± 4.8° and Ex8.3° ± 4.9°, respectively. No statistically significant differences were seen in either group of the subjects between the measurements by the major amblioscope and our instrument. <br>2. Before strabismus surgery, cyclodeviation by the major amblyoscope and cyclodeviation in the seated and supine positions by the new instrument were Ex18°, Ex19°, and Ex19°, respectively. During the surgery, the remaining cyclodeviation was measured in a supine position by the new instrument and the surgery was terminated when cyclodeviation reached a level of Ex6°. Ten days after the surgery, cyclodeviations by the two devices in both positions were all Ex7° and the patient's cyclodiplopia disappeared.<br>[Conclusion] With this new instrument, the measurements in both positions did not differ significantly and the measurement accuracy was comparable to that of a major amblyoscope. During a strabismus surgery, if the remaining cyclodeviation is accurately measured, postoperative diplopia resulted from residual strabismus can be prevented and the number of surgeries needed can also be reduced to the lowest possible level.

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