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Biomedical subjects

W de Decker

Publications and source records attributed to W de Decker.

At least 37 records · Page 2Linked to original sources
PubMed1983

Constant or apparently constant congenital esotropia? A survey of 304 Fadenoperations.

Cüppers (6) presented the Fadenoperation (Fd) as a splendid tool to correct inconstant squint angles by means of an artificial paresis. The author's practice shows that many cases of apparently constant congenital esotropia, successfully treated by Fd, obviously would be better interpreted as permanently overinnervated adduction excess cases. But even a sophisticated view of the mechanism of the Fd cannot solve the problem of whether or not a stable basic angle really exists in children before the age of five years. The paper, in addition, deals with the results of 304 cases of alternating congenital esotropia and the author's own techniques.

Child, Preschool↗
PubMed1982

[Catalog of direct eye muscle injuries].

Eye muscle injuries may occur in isolation or concomitantly with orbital fractures. Depending on their mechanical cause they may be encountered in the form of contusions, overextensions or injuries caused by stabbing or cutting. The authors present case histories from their own patient collective in this order, supplemented by a number of cases described in the literature. Particular attention is paid to the superior oblique, injuries to which are almost without exception trochlear or pretrochlear. The special anatomy of the tendon is a factor that may explain restrictions in motility in upward and downward gaze (dysfunctions). Certain severe cases are described and the principles of reconstructive surgery are discussed.

Adult↗
PubMed1981

[Kestenbaum transposition for treatment of retraction syndrome (author's transl)].

In pronounced forced attitude in consequence of retraction syndrome, abduction capacity with good head posture can be attained by Kestenbaum transposition. The advantages are in the retention of the motility present, with a more favorable distribution. At the same time, an exophoria for the previously most favorable glance direction is avoided. Proportioning must be small because of the stiffness of the muscles (4 to 6 mm). In less pronounced cases, the indication is not quite so convincing. Proportioning and problems arising from the stiffness of the muscles are briefly discussed. Where strabismus verus is also present squint operations and transpositions should be performed in separate sessions.

Adult↗
PubMed1981

[Binocular sensory defects in intermittent divergent strabismus].

Intermittent divergent strabismus represents an entity in terms of motoric characteristics rather than in its sensorial basis. Separate investigations were carried out in two clinics on 156 patients. The results were evaluated together, the authors discussing each case. Only in 27 cases was the condition cured. The main group comprised 78 patients with subnormal binocular vision based on facultative microexotropia and instable/normal correspondence. Basic microexotropia with obligate ARC was found in 51 cases, i.e., more often than expected. Testing the stereo threshold proved to an inadequate criterion for cure.

Adult↗
PubMed1981

The Faden operation. When and how to do it.

The Faden operation (posterior fixation of a muscle) creates an artificial palsy. With this tool the eye surgeon can solve problems concerning palsies, nystagmic amblyopia, and many cases of head posture. Changing angles in children with congenital strabismus can be stabilized by bilateral Faden operations on the medial rectus. The results are given of a retrospective analysis of nearly 400 cases operated 3 years ago. The paper deals with some of the technical problems and ends with some remarks on postoperative motility after Faden operations.

Adult↗
PubMed1980

Kestenbaum transposition operation for treatment of the Duane I retraction syndrome.

In cases of marked head turn due to Duane's retraction syndrome, abduction ability with a good posture may be obtained by Kestenbaum's muscle transposition. The advantages of this operation are retention of motility with a better distribution of muscular power. At the same time exophoria in the previously favoured direction of gaze is avoided. The degree of transposition must be small (4 to 6 mm) because of the strength of the muscles. In less pronounced cases of head turn the indications for this operation are less obvious. The amount of transposition and the problems caused by the strength of the muscles have to be carefully considered. If strabismus is also present, the operations for squint and for the Duane's retraction should be performed at separate sessions.

Adolescent↗
PubMed1979

[Improvement of fixation by early Fadenoperation (clinical and experimental observations) (author's transl)].

17 children aged 6 months to 2 1/2 years with strabismus convergence, amblyopia and overconvergence were treated with Fadenoperation on the medial rectus of the deviating eye, after therapy with occlusion had not been tolerated. In all cases tolerance of the occlusion had been achieved, central fixation in 15, unrestricted abduction in 9 children. The period of observation ranged from 18 to 24 months. Repeated controls after Fadenoperation on infantile rabbit's eyes and echografic measurements on 6 patients have stated that there is no danger of a restriction in the bulbus growth. As late retinal complication following Fadenoperation cannot be excluded, a serious indication is recommended.

Age Factors↗
PubMed1979

[Strabismus in cerebral paretic and normal children. Comparison of motoric symptoms (author's transl)].

Investigations of 94 children with cerebral palsies have shown 55% strabismus incidence. Motoric symptoms like varying angles, nystagmus (latens), A-V phenomena, dissociated hypertropia and compulsive head postures are presented, frequently more often than in a number of comparison cases of undamaged squinting children. However, these symptoms have not permanently been found even in severly damaged children. With the exception of compulsive head postures, no symptoms are found in strabismus cases of cerebral paretic children that do not occur in congenital strabismus patients as well. A frequent family heredity strain of strabismus has also been noted. There is a striking proportion of divergence cases (27%). The authors do not believe in a simple damaging etiology. Pleoptic-orthoptic exercises are hardly ever practicable. Early operation may improve the initial situation as far as the neuropediatric therapy is concerned.

Adolescent↗
PubMed1978

["Kestenbaum's surgical rotation of the eyes" in patients with head tipped to the shoulder (author's transl)].

The principle of Kestenbaum's surgical rotation of the eyes has been found applicable to cases with head tilt to the shoulder. With restriction to the anterior parts of the obliques, which are acting mainly rotatory, the authors were able to release 9 patients out of 25 from their abnormal head posture with their operation. 12 showed definite improvement. However, the pathophysiology and the abolition of the head tilt to the shoulder could not alltogether be explained yet. Latent nystagmus with a resting position is found in only two out of three, a rotatory component only in one out of three patients. The authors believe that the picture of head tilt to the shoulder may rather be located within the classification of congenital strabismus syndrome (Lang) than within a strict causal classification after a certain type of nystagmus.

Child↗
PubMed1976

[Subnormal binocular vision -- principles for the classification of microstrabismus (author's transl)].

The studies of several hundred case records, most of them carefully observed for years, show that a simple definition of microstrabismus is not sufficient. Contrary to usual opinions about correspondence problems 7% of these cases were even found to be corresponding normally. One third of the cases remained unstable in their sensory behavior. In our opinion combinations of 4 sensopathological prinicples allow a better description of the clinical findings in cases showing a more complicated state. The 4 prinicples are 1. haziness of cortical connections, 2. rivalry of more than one correspondence, 3. horror fusionis, 4. inherited amblyopia -- inborn lack of monocular capacity. Furthermore it can be demonstrated that the four prinicples match with recent findings in neurophysiology and neuroanatomy.

Adult↗
PubMed1975

[Fixation disparity in peripheral and central binocular vision under conditions of prismatic heterophoria (author's transl)].

A critical review of the literature shows that there are controversal interpretations of thephenomenon fixation disparity. The former findings of Ogle and coworkers are ascertained byinvertigator to close the central gap in the fusional patter. Formerly the gap was essentialdue to polarisation techiques. 1. Without central gap fixation disparity decreases, but remainssignificantly different from zero. 2. Diminution or closing of the gap leads to more preciseresults, since the position of the eyes is better controlled. 3. Straining the binocular vision with high prism power cortical tolerances increase when fusion was aided by central stimuli. Fixation disparity could be extended up to 20' (minutes of are) which is three times the well accepted size of the Panum area.

Fixation, Ocular↗