BIOMECHANICAL ANALYSIS IN STRABISMUS SURGERY

斜视手术中的生物力学分析

• 批准号: 6627151
• 负责人: Joel M Miller
• 金额: $ 42.64万
• 依托单位: SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6627151
• 关键词: Primates; biomechanics; computed axial tomography; computer simulation; connective tissue; extraocular muscle; eye coordination disorder; eye disorder diagnosis; eye laser surgery; eye movement disorders; eye movements; eye surgery; human tissue; immunocytochemistry; implant; magnetic resonance imaging; microcapsule; model design /development; muscle function; postoperative state; radiography

DESCRIPTION (Adapted from Applicant's abstract): Significance: Strabismus, misalignments of the visual axes, is prevalent in the US and usually treated surgically. Misdiagnoses and sub-optimal outcomes are predictable consequences of inadequate understanding of extraocular anatomy and oculomotor control. Our overall aim is to develop a quantitative, physiologically realistic understanding of extraocular biomechanics, applied to diagnosis and treatment of strabismus. We previously showed that distributed midorbital connective and smooth muscle tissues function as rectus extraocular muscle (EOM) pulley, crucial to normal ocular kinematics. Recent studies suggest that the global lamina of each EOM rotates the eye, whereas the orbital lamina translates the pulley that determines the global lamina's functional origin. More complete characterization of extraocular tissue architecture should reveal other mechanically significant structures, also not easily discriminable because distributed. These findings, and out direct physiologic muscle force measurements have cast doubt on the classic and fundamental oculomotor concept of the Final Common Path. Validation and development of these ideas will continue to have broad impact on laboratory studies of ocular motility and on diagnosis and treatment of strabismus. Studies: We will: (01) test predictions of differential contraction of global and orbital EOM laminae and movements of connective tissue pulleys with conjugate and vergence eye movements, using implanted gold microspheres and digital X-ray imaging in alert monkeys; (2) characterize extraocular tissue architecture by reconstructing multiple interlaced immunohistochemically stained thin serial sections of cadaveric human and monkey orbits; (3) test the Active Pulley Hypothesis, a challenge to the classic notion of the Final Common Path, using physiologic muscle force measurement in alert monkeys, and (4) develop scientifically and clinically useful biomechanical modeling tools that reflect current physiologic findings and hypotheses.

描述（根据申请人的摘要改编）：意义：斜视， 视觉轴未对准，在美国很普遍，通常治疗 外科手术。误诊和亚最佳结果是可预测的后果 对眼外解剖学和眼动物控制的理解不足。我们的 总体目的是开发一种定量，生理现实的 了解眼外生物力学，应用于诊断和治疗 斜视。我们之前表明，分布式的腰椎结缔组织和 平滑肌组织充当直肠外肌（EOM）皮带轮， 对正常的眼运动学至关重要。最近的研究表明全球 每个EOM的薄片旋转眼睛，而轨道薄片则翻译 决定全球薄片功能起源的滑轮。更完整 眼外组织结构的表征应揭示其他 机械意义的结构，也不容易区分，因为 分布式。这些发现以及直接生理肌肉力量 测量值对经典和基本的眼动概念表示怀疑 最终的公共路径。这些想法的验证和发展将 继续对眼运动的实验室研究产生广泛的影响 斜视的诊断和治疗。 研究：我们将：（01）测试全局差分收缩的预测 和轨道EOM薄片以及结缔组织皮带轮的运动 使用植入的金微球和偶联的眼睛运动 警报猴子中的数字X射线成像； （2）表征眼外组织 通过重建多个交错的免疫组织化学来结构 尸体人和猴子轨道染色的薄串行部分； （3）测试 主动滑轮假设，对最终普通的经典概念的挑战 路径，在警报猴子中使用生理肌肉力量测量，（4） 开发科学和临床上有用的生物力学建模工具 反映当前的生理发现和假设。