Same-day surgery mode is an efficient medical mode, and the key point of its management is multidisciplinary collaboration optimization of the process and integration of enhanced recovery after surgery concept. This paper introduces the establishment of multidisciplinary collaboration system, clinical pathway maintenance, patient visit procedure optimization, preoperative and postoperative care and follow-up management of same-day surgery mode for children with strabismus correction under general anesthesia at West China Tianfu Hospital of Sichuan University, aiming to promote the further improvement of the pediatric same-day surgery process and provide a reference for the promotion of the pediatric same-day surgery mode.
Objective To investigate the efficacy of individualized surgical treatment on congenital superior oblique paralysis. Methods A total of 131 patients (180 eyes) undergoing surgery for congenital superior oblique palsy between October 2015 and January 2018 in West China Hospital of Sichuan University were reviewed. The clinical features, surgical methods and efficacy were analyzed. Results Among the 131 cases, 49 cases were bilateral congenital superior oblique palsy, and 82 cases were unilateral congenital superior oblique palsy; 94 cases were combined with horizontal strabismus; 17 cases (26 eyes) underwent inferior oblique recession, 53 cases (93 eyes) underwent superior oblique tuck, 4 cases underwent superior oblique tuck combined with contralateral superior rectus resection, 37 cases underwent superior oblique tuck combined with contralateral inferior rectus recession, 6 cases underwent inferior oblique recession combined with contralateral superior rectus resection, and 14 cases underwent inferior oblique transposition combined with contralateral superior rectus resection; 18 cases underwent horizontal strabismus correction at one stage, and 76 cases underwent horizontal strabismus correction at the second stage. After Surgery, there were 116 cases cured (88.55%), 15 cases improved (11.45%), and 0 case invalid. Conclusions The diagnosis of congenital superior oblique paralysis should be accurate. Individualized surgery should be designed according to the size and maximum orientation of the squint and the limitation or hyperactivity of the muscles in each diagnostic eye position.
Pattern-reversal electroretinograms(P-ERG)and visual evoked potential(P-VEP) were simultaneously recorded in 20 kittens reared with unilateral convergent strabismus,induced surgically at around 3 weeks after birth.P-VEP responses evoked through the normal and squint eyes consisted of two components at the initial stages,however changed systematically with age,and the second component of the squint eye disappesred earlier than that of the normal eye.P-ERG response for the variance in retinal function of squint eyes was more sensitive than the F-ERG.P-VEP responses from the squint eyes reduced significantly in amplitude as compared with those evoked through the normal eyes,even one week after surgery,while P-ERG responses unchanged and persisted through 30 weeks.Reduction of P-ERG amplitude of squint eyes developed about 6 weeks postnatal and the spatial resolution returned gradually at later stages.The results suggest that the strabismus may affect not only striate cortex,but also retina in developing kittens.In comparison with retinal deficits,cortical deficits may arise earlier and manifest more severe.
Objective To detecte the pathogenetic mechanism of cortical deficit in persons with strabismic amblyopia by blood oxygenation level dependent-functional magnetic resonance imaging(BOLD-fMRI)． Methods The data of BOLD-fMRI of occipital visual cortex in 11 persons with strabismic amblyopia and 8 healthy ones were collected by 1．5T MRI system．The results of binocular pixel exponent in strabismic amblyopia group was compared with that in the normal group and the result of and average activation of cortical neuron in strabismic amblyopia group was analyzed.Results The binocular pixel exponent was lower in the strabismic amblyopia group(14．13％±4．55％)than that in the normal group(47．82％±5．34％)(PConclusions The reduction of cortical binocular cells and the undersampling and coding of higher-spatial-frequency components of visual stimuli may be related to the strabismic amblyopia．BOLD-fMRI may provide a new path to detecte the pathoffenetic mechanism of cortical deficit in people with strabismic amblyopia. (Chin J Ocul Fundus Dis，2004，20：19-22)
We have utilized the binocular flat and stereoscopic pattern to record visual evoked potentials (VEP) in normal and strabismic subjects. The aim was to find an electrophysiological correlation with the degree of binocular interaction in these subjects.The perception as tridimensional or flat derived from the disparity obtained with polaroid filters placed in front of the eyes. In normal subjects, the results demonstrated a significant increase of VEP amplitude during tridimensional perception of the pattern. In strabismic subjects the electrophysiological response were not correlated with the binocular conditions. The findings in the present study suggest that the binocular disparity in VEP examination is a useful technique and a better objective index for evaluating stereoscopic function than the psychophysical technique. （Chin J Ocul Fundus Dis,1992,8:10-13）