BIOMECHANICAL ANALYSIS IN STRABISMUS SURGERY

描述（改编自申请人摘要）：意义：斜视， 视轴失调，在美国很普遍，通常治疗 外科手术误诊和次优结果是可预见的后果 对眼外解剖结构和眼球控制的理解不足。我们 总体目标是制定一个定量的，生理上现实的 了解眼外生物力学，应用于诊断和治疗 斜视我们以前表明，分布眶中结缔组织和 平滑肌组织起着眼外直肌（EOM）滑轮作用， 对正常的眼部运动至关重要最近的研究表明，全球 每个眼外肌的板层旋转眼睛，而眶板层平移眼睛。 滑轮，决定了全球椎板的功能起源。更完整 眼外组织结构的表征应该揭示其他 机械上重要的结构，也不容易区分，因为 发放这些发现，直接与生理肌肉力量 测量结果使人们对经典的和基本的视力概念产生了怀疑， 这些想法的确认和发展将 继续对眼能动性的实验室研究和 斜视的诊断和治疗。 研究：我们将：（01）测试全球差异收缩的预测 和眼眶眼外肌层和结缔组织滑轮的运动， 共轭和聚散眼球运动，使用植入的金微球， 警觉猴的数字X射线成像;（2）表征眼外组织 多重交错结构化学重构建筑 人和猴尸体眼眶的染色薄连续切片;（3）测试 主动滑轮假说，对经典的最终共同点概念的挑战 路径，在警觉的猴子中使用生理肌肉力量测量，和（4） 开发科学和临床上有用的生物力学建模工具， 反映了当前的生理发现和假设。

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.