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.
Surgical technique combining vertical transposition and horizontal plication for mixed deviations
Reviewed by Lauren Hepworth
Plication combined with vertical displacement of horizontal rectus muscles to treat combined horizontal and vertical deviations.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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