BIOMECHANICAL ANALYSIS IN STRABISMUS SURGERY

描述(摘自申请者摘要)：意义：斜视， 视轴错位在美国很普遍，通常治疗 从外科手术开始。误诊和次优结果是可预见的后果 对眼外解剖和眼球运动控制的了解不足。我们的 总体目标是开发一种定量的、生理上现实的 眼外生物力学的认识及其在诊疗中的应用 斜视的症状。我们之前已经证明了分布在眶中的连接性和 平滑肌组织充当眼外肌(EOM)滑轮， 对正常的眼球运动学至关重要。最近的研究表明，全球 每个EOM的椎板旋转眼睛，而眼眶椎板平移 滑轮决定了全局椎板的功能起源。更完整 眼外组织结构的特征应该揭示其他 机械上有意义的结构，也不容易区分，因为 分布式的。这些发现，以及直接的生理性肌肉力量 测量结果令人怀疑经典的、基本的动眼神经概念 最终的共同路径。对这些想法的验证和开发将 继续对眼球运动的实验室研究产生广泛影响 斜视的诊断和治疗。 研究：我们将：(01)测试全球经济差异收缩的预测 和眼眶EOM板层和结缔组织滑车的运动 共轭和会聚眼球运动，使用植入的黄金微球 警觉的猴子的数字X射线成像；(2)眼外组织的特征 通过免疫组织化学重建多个交错的架构 人、猴身体眼眶的染色薄层连续切片；(3) 主动滑轮假说--对经典的终极公理观念的挑战 Path，在警觉的猴子中使用生理性肌力测量，以及(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。

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.