Surgical technique combining vertical transposition and horizontal plication for mixed deviations
Reviewed by Lauren Hepworth

A retrospective case series, assessed adult cases with horizontal and vertical strabismus who had undergone unilateral vertical transposition of the horizontal rectus muscles during a recession-plication over a three-year period. A single surgeon performed all 15 procedures. Postoperative measurements were conducted by a second ophthalmologist. Exclusion criteria included horizontal deviation being smaller than 15∆ and larger than 60∆, prior strabismus surgery and a cranial nerve palsy diagnosis. A detailed description of the surgical technique is provided. A total of 15 cases were included in the analysis, nine of which were medial rectus and six lateral rectus plications. The size of vertical deviation ranged from 8∆ to 20∆. Following surgery, 14 cases had no vertical deviation and only four cases had a horizontal deviation greater than 10∆. No complications were reported. The authors acknowledge the limitations of the study including the retrospective methodology, lack of a control group, variation in follow-up timepoints. The feasibility of this surgical technique has been demonstrated by this case series.

Plication combined with vertical displacement of horizontal rectus muscles to treat combined horizontal and vertical deviations.
Meireles-Teixeira JA, Mesquita MJTAM, Demachki NT, Mendonça TFS.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2022;26(4):178.