VERTICAL DISPLACEMENT OF HORIZONTAL RECTI FOR CORRECTION OF VERTICAL DEVIATION AND A/V PATTERNS
K. Vanselow, A. Zubcov, M. Hacker, C. Klais, N. Stärk
A retrospective study to evaluate whether there is a dosis dependent effect of the displacement of horizontal recti on the postoperative vertical deviation. and whether A/V pattern (without influence of obliqui muscles) can be corrected sufficiently by displacement.
Method: Analysis of single cases with the diagnosis congenital elevator palsy (n=1), oculomotor palsy (n=2), combined horizontal and vertical deviation (n=6), A- and V-pattern (n=2). Either a transposition was performed alone (n=1) or in combination with recess-resect surgery (n=10) with a displacement of 1/2 or 1 muscle width. Follow up was between 1 and 48 months.
Results: In congenital and oculomotor palsy the correction of vertical deviation was 18PD to 22PD. All of the combined horizontal and vertical deviations reached a postoperative reduction of vertical deviation within +/- 5PD, while the horizontal deviation was corrected within +/-8PD. The A- and V-pattern showed a successful reduction within +/-4PD for upgaze, primary position and downgaze.
Conclusion: For specific indications displacement of horizontal recti offers a satisfying correction of vertical deviation coexisting with a horizontal deviation when at the same time resess-resect surgery is performed on the displaced muscles. Displacement of 1 muscle width results in correction of the vertical deviation of 18PD to 22PD.
Department of pediatric ophthalmology and strabism, J.W. Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt