Pujari Amar, Rakheja Vaishali, Modaboyina Sujeeth, Das Deep, Tripathi Manasi, Phuljhele Swati, Saxena Rohit, Agarwal Tushar, Sharma Namrata, Titiyal Jeewan S
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Eur J Ophthalmol. 2022 Jul;32(4):1978-1990. doi: 10.1177/11206721211045190. Epub 2021 Sep 8.
To describe the possibility of complex strabismus surgical simulation on goat eyes.
The goat eyes were procured from local slaughterhouse with retained extra ocular muscle tissues. The obtained eyes were inspected for globe integrity, muscle quality, muscle length, and the surrounding teno-conjunctival layers. The included eyes were then segregated for surgical simulation based on their insertion and orientation (as oblique or recti), and they were mounted on a mannequin head, with a fixation suture at free end to simulate the resting tension. Additionally, as per necessary, extra muscles were also transplanted along desired sites to simulate human extra ocular muscle anatomy.
The inferior oblique, superior oblique, and all other four recti were successfully simulated in varying proportions in more than 50 eyes. Primarily, by simulating the lateral rectus, inferior rectus, and the inferior oblique muscle, staged weakening procedures of inferior oblique were successfully practiced (Fink's recession, Park's recession, Elliot and Nankin procedure, total anterior positioning, and antero-nasal trans-position or Stager's procedure). Similarly, by simulating superior rectus, inferior rectus, lateral rectus, and the medial rectus muscles, half width transposition, full width transposition, and other complex procedures were practiced (Knapp's procedure, augmented Knapp's, Nishida's procedure, Faden operation, and Y splitting procedure). Furthermore, by simulating superior oblique and the superior rectus muscles, superior oblique tuck, posterior tenectomy, loop tenotomy, and Harada Ito procedures were successfully practiced.
On goat eyes, the complex strabismus surgical procedures can be successfully simulated and practiced after re-organizing the existing muscles in different patterns.
描述在山羊眼上进行复杂性斜视手术模拟的可能性。
从当地屠宰场获取保留眼外肌组织的山羊眼。检查所获得的眼睛的眼球完整性、肌肉质量、肌肉长度以及周围的腱结膜层。然后根据其附着点和方向（如斜肌或直肌）将纳入的眼睛分类以进行手术模拟，并将它们安装在人体模型头部，在自由端使用固定缝线以模拟静息张力。此外，根据需要，还沿着期望的部位移植额外的肌肉以模拟人类眼外肌解剖结构。
在50多只眼睛中成功地以不同比例模拟了下斜肌、上斜肌以及所有其他四条直肌。主要通过模拟外直肌、下直肌和下斜肌，成功实施了下斜肌的分期减弱手术（芬克后徙术、帕克后徙术、埃利奥特和南金手术、完全前部定位以及前鼻移位或斯塔格手术）。同样，通过模拟上直肌、下直肌、外直肌和内直肌，实施了半宽度移位、全宽度移位以及其他复杂手术（克纳普手术、改良克纳普手术、西田手术、缝线固定术以及Y形劈开手术）。此外，通过模拟上斜肌和上直肌，成功实施了上斜肌折叠术、后部肌腱切断术、套环肌腱切断术以及原田伊藤手术。
在山羊眼上，通过以不同模式重新组织现有肌肉，可以成功模拟和实施复杂性斜视手术。
