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Biomedical subjects

M M Parks

Publications and source records attributed to M M Parks.

At least 37 records · Page 2Linked to original sources
PubMed1990

Glaucoma in oculo-dento-osseous dysplasia.

Two patients with oculo-dento-osseous dysplasia developed glaucoma in infancy or early childhood. Aggressive surgical management resulted in the preservation of vision in both patients in at least one eye. A review of published reports disclosed that glaucoma in oculo-dento-osseous dysplasia develops at different ages and is possibly secondary to a variety of mechanisms. Glaucoma is the main cause of visual loss in this syndrome, for which patients otherwise have a good prognosis for life and intellect. Early screening for glaucoma in oculo-dento-osseous dysplasia is mandatory, especially when there are symptoms that suggest high intraocular pressure.

Abnormalities, Multiple↗
PubMed1990

Recognition and repair of the "lost" rectus muscle. A report of 25 cases.

Twenty-five consecutive cases of lost muscle over a 10-year period are presented with regard to etiology, clinical presentation, operative findings, and treatment results. All patients showed a large-angle strabismus and all muscles had marked limitation of excursion in its field of action. This complication of ocular surgery or trauma, unlike the slipped muscle which has its empty capsule attached to the sclera, is characterized by the absence of any attachment of the muscle or its capsule to the sclera. Eleven of the 25 muscles were retrievable largely because of attachments through intermuscular septum to adjacent oblique muscles. The remaining 14 muscles were considered irretrievable, and these patients underwent a muscle transposition procedure. The clinical features and surgical repair of the lost muscle are described and compared with those of the slipped muscle.

Humans↗
PubMed1990

Results from 7-mm bilateral recessions of the medial rectus muscles for congenital esotropia.

We reviewed the surgical records of 77 patients who had undergone 7-mm bilateral medial rectus recessions for large-angle congenital esotropia. The mean age of onset of esotropia in these patients was 3.5 months, and the mean age at the time of surgery was 12.9 months. The mean preoperative deviation was 69 delta of esotropia. This procedure resulted in satisfactory horizontal alignment in 47 patients (61%) at their latest follow-up examination (mean, 27 months; range, 6 months to 6 years). The esotropia was undercorrected in 21 patients (27%) and overcorrected in nine (12%). Amblyopia was noted in 30%, oblique muscle dysfunction in 44%, and dissociated vertical deviation in 36% of the patients. Regression analysis of multiple variables showed alignment at 6 weeks to be the only predictor of the final outcome (R = .83). Extramacular fusion was achieved in 10 of 11 patients for whom reliable sensory data were available. The mean age at surgery of these patients was 9.7 months. Seven-millimeter bilateral medial rectus recessions are an effective alternative to three- and four-muscle procedures in the initial treatment of large-angle congenital esotropia during infancy.

Amblyopia↗
PubMed1989

Primary inferior oblique overaction in congenital esotropia, accommodative esotropia, and intermittent exotropia.

A statistical analysis of the onset and natural history of primary inferior oblique eye muscle overaction (IOOA) was conducted using the records of 456 strabismus patients. With 5 years or more of follow-up, IOOA developed in 72% of congenital esotropes (CETs), 34% of accommodative esotropes (AETs), and 32% of intermittent exotropes (X[T]s) at an average age of 3.6, 5.2, and 5.2 years, respectively. Incidence of IOOA was positively related to the number of horizontal surgeries in CETs but not in AETs or X(T)s. Incidence was not related to age of onset of strabismus, time from onset of strabismus to surgery, age at first surgery, or decompensation of ocular alignment. Mild IOOA did revert to normal in 12 patients after only horizontal surgery. The association of IOOA with dissociated vertical deviation, as well as symmetry, range of age of detection, and recurrence after surgery are also explored.

Accommodation, Ocular↗
PubMed1988

Congenital esotropia vs infantile esotropia.

The term congenital esotropia has been challenged for many years. The basis of this challenge is that the deviation is not confirmed connatally. However, the term congenital esotropia is valid based on clinical observations and is easily separated from other forms of acquired esotropia.

Age Factors↗
PubMed1987

Simultaneous superior oblique tenotomy and inferior oblique recession in Brown's syndrome.

The technique and results of simultaneous superior oblique tenotomy and 14-mm inferior oblique recession for true Brown's syndrome are presented for 16 eyes of 13 patients. A good or excellent result was achieved in 15 of 16 eyes (94%). Reoperation for overcorrection was not necessary; however, repeat tenotomy was required in two cases. Inferior oblique underaction was present in 12 of 16 eyes (75%) in the early postoperative period; however, elevation in adduction improved over time. At most recent examination, 92% of eyes demonstrated greater than 25 degrees elevation in adduction. Underaction of the superior oblique occurred in 3 of 16 eyes (19%). A simultaneous superior oblique tenotomy and inferior oblique recession is recommended in all patients selected to undergo surgery for true Brown's syndrome to prevent reoperation for iatrogenic superior oblique palsy.

Adolescent↗
PubMed1986

After the eyes are straightened what is the ophthalmologist's responsibility?

Occlusion, glasses, prism therapy, miotics, fusional vergence stimulation, plus more surgery are required frequently in various combinations for a high percentage of patients whose strabismic eyes are straightened by surgery. Amblyopia is a serious sequelae befalling children who are dismissed following satisfactory surgery. Their best possible postoperative status is monofixation (absence of bifixation), despite having straight eyes. Unless they alternate fixation, amblyopia is prone to either occur or recur. Also, either a gradual change in motor innervation to the extraocular muscles or a cicatricial scarring process may subtly cause subsequent strabismus. Hence, despite straight eyes postoperatively the surgeon's responsibility continues.

Amblyopia↗
PubMed1986

Familial congenital superior oblique palsy.

Four pedigrees, each with two or more cases of congenital superior oblique palsy among immediate family members, are presented. Except for a single case report in 1926, this disorder has not been known to occur in a hereditary manner. Theories of pathogenesis of congenital fourth cranial nerve palsy are discussed, with special reference to the hereditary occurrence of this disorder. Analogy is drawn between the familial forms of congenital superior oblique palsy and Duane's syndrome.

Adolescent↗
PubMed1984

Congenital esotropia with a bifixation result. Report of a case.

Surgical alignment of the eyes in congenital esotropia within the first two years of age can result in the development of binocular vision. With one exception, reported here, the binocular vision has been extramacular and never macular. In this one case the patient was proven to be a bifixator. This is such an unusual outcome that the diagnosis of congenital esotropia must be questioned. Moreover, dissociated double hypertropia was not found in this case.

Esotropia↗
PubMed1984

Incidence of chronic glaucoma, retinal detachment and secondary membrane surgery in pediatric aphakic patients.

The eyes of 392 consecutive childhood cataract aspiration procedures were analysed for frequency of the development of chronic glaucoma and retinal detachment and the performance of secondary membrane surgery. Three different modifications of the aspiration procedure were employed: the standard needle and syringe procedure leaving the posterior capsule intact (304 eyes), rotoextraction with small opening of the posterior capsule (34 eyes) and Ocutome aspiration with wide excision of the posterior capsule (54 eyes). The mean postoperative follow-up was 5.5 years. Chronic glaucoma was found in 6.1% of the eyes. Coexisting ocular anomalies and retained lens cortex increased the risk for this complication. Retinal detachment was found in 1.5% of the cases. Coexisting ocular anomalies and uncontrolled vitreous disturbance increased the possibility of retinal detachment. Secondary membrane procedures were performed in 62% of the eyes in which the aspiration procedure left the posterior capsule intact, in nearly 12% of those in which the posterior capsule was minimally opened and in none of those which had the posterior capsule widely excised. The secondary membrane surgery itself appeared to increase the risk for both glaucoma and retinal detachment. The aspiration procedure with the lowest incidence for all three complications was the Ocutome aspiration with wide excision of the posterior capsule.

Adolescent↗