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T. Haslwanter, R. Hoerantner, M. Buchberger, T. Kaltofen, S. Priglinger; Model Based Improvements in the Treatment of Strabismus . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2349.
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Purpose:To Understand the Biomechanics of Strabismus. Methods:We have investigated four patients with "heavy eye syndrome", and more than ten additional highly myopic subjects. The "heavy eye syndrome" is an eye motility disorder characterized by high myopia, an enlarged bulb, and a concomitant hypertropy of the affected eye. The hypertrophy has so far been assigned to the rectus muscles. Before the operation, we used SEE++, a computer based 3–dimensional model of the oculomotor plant, to find the most likely cause of the observed strabismus pattern. Results:Our simulations indicate that for the "heavy eye patients" a dislocation of the superior oblique probably has a larger influence than a dislocation of the rectus muscles. MRI recordings in a patient with the "heavy eye symptom" confirmed the suspected dislocation of the superior oblique, supporting our modeling approach. We also used SEE++ to determine surgical parameters for the treatment of the patients. The post–surgical results showed a good match with the predictions of SEE++. For the highly myopic patients, SEE++ was not only able to reproduce successful surgeries, but even correctly predicted the remaining strabismus patterns after the surgeries. Conclusions:We show that for complex eye movement disorders, computer–based models can provide new insights into the causes of the pathologies. They can also help to optimize the parameters for the surgical treatment of the patients.
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