Rüssmann W
Schielbehandlung und Neuroophthalmologie, Klinik und Poliklinik für Augenheilkunde der Universität zu Köln.
Klin Monbl Augenheilkd. 1996 Jan;208(1):27-32. doi: 10.1055/s-2008-1035164.
Two different program systems can be used when planning squint surgery. In the first system's algorithms (Robinson-Miller-Simonsz) are modelled the mechanical and innervational laws that govern eye movements (ophthalmotrope program). With ocular deviations and surgical procedures as input the program estimates postoperative deviations. The second program (Rüssmann-Konen) mimics any surgeon's planning of squint surgery using a defined decision tree and an appropriate number of mm-degree-relations (planning program). If ocular deviations, axial length, monocular excursions, and head posture are input the program proposes a surgical procedure. I combined both programs to enable the ophthalmotrope program to evaluate the propositions of the planning program.
I translated Simonsz' version 1/1989 of Robinson's program from FORTRAN to the programming language of my planning program (Turbo BASIC for IBM-PC) and connected both, the former becoming a module of the latter. Thus data entered into the planning program as well as the surgical procedure proposed may be immediately processed by the ophthalmotrope program to compute the presumed postoperative result. Several program loops allow a wide variation of data and procedures in successive program runs. Turbo BASIC being somewhat slower than FORTRAN quick computers (INTEL 80486, Pentium) are necessary lest processing lasts more than 1 minute.
A concomitant esotropia of 20 degrees and a head posture with elevation of the chin of 20 degrees are used to illustrate program properties. In the first case the planning program proposes a reasonable recess-resect-procedure 6 mm each, which is estimated to give a very slight overcorrection by the ophthalmotrope module. In the second case the planning module proposes a gaze shift procedure (Kestenbaum) on the vertical recti, which--in good agreement with my own experience--is estimated to produce an A-phenomenon of 19 degrees with an incyclotropia up to 30 degrees by the ophthalmotrope module. If an anterior margin recession of the superior oblique and an anterior margin tuck of the inferior oblique are added to the gaze shift procedure in both eyes neither any phenomenon nor any significant deviation are predicted by the ophthalmotrope module.
The combination of a planning module with an ophthalmotrope module in one program considerably enhances the usefulness of both.
斜视手术规划时可使用两种不同的程序系统。第一种系统的算法（罗宾逊 - 米勒 - 西蒙斯算法）模拟了控制眼球运动的机械和神经支配规律（眼动仪程序）。以眼位偏斜和手术操作作为输入，该程序可估算术后眼位偏斜情况。第二种程序（吕斯曼 - 科嫩程序）使用定义的决策树和适当数量的毫米 - 度数关系来模拟任何外科医生的斜视手术规划（规划程序）。如果输入眼位偏斜、眼轴长度、单眼运动范围和头部姿势，该程序会提出一种手术操作方案。我将这两种程序结合起来，使眼动仪程序能够评估规划程序提出的方案。
我将西蒙斯1989年版的罗宾逊程序从FORTRAN语言翻译成我的规划程序所使用的编程语言（适用于IBM - PC的Turbo BASIC），并将两者连接起来，前者成为后者的一个模块。这样，输入到规划程序中的数据以及提出的手术操作方案都可以立即由眼动仪程序进行处理，以计算预期的术后结果。几个程序循环允许在连续的程序运行中对数据和操作进行广泛的变化。由于Turbo BASIC比FORTRAN慢一些，因此需要快速计算机（英特尔奔腾80486、奔腾），以免处理时间超过1分钟。
以20度的共同性内斜视和20度的下巴上抬头部姿势为例来说明程序的特性。在第一种情况下，规划程序提出了一个合理的双侧各6毫米的后徙 - 切除手术方案，眼动仪模块估计该方案会导致非常轻微的过矫。在第二种情况下，规划模块提出了垂直直肌的注视转移手术（凯斯滕鲍姆手术），根据我的经验，眼动仪模块估计该手术会导致19度的A现象和高达30度的内旋转斜视。如果在双眼的注视转移手术中增加上斜肌前缘后徙和下斜肌前缘折叠手术，眼动仪模块预测既不会出现任何现象也不会出现任何明显的偏斜。
在一个程序中结合规划模块和眼动仪模块可显著提高两者的实用性。
