Surgery for Complete Vertical Rectus Paralysis Combined with Horizontal Strabismus

Abstract EN

Aims.

To report outcomes of the simultaneous surgical correction of vertical rectus paralysis combined with moderate-to-large angle horizontal strabismus.

Methods.

If a preoperative forced duction test was positive, antagonist muscle weakening surgery was performed, and then augmented partial rectus muscle transposition (APRMT) + partial horizontal rectus recession-resection was performed 2 months later.

If a preoperative forced duction test was negative, APRMT + partial horizontal rectus recession-resection was performed.

Antagonistic muscle weakening surgery and/or conventional recession-resection of the horizontal and/or vertical muscles of the contralateral eye was performed 2 months later, as needed.

Results.

Ten patients with a mean age of 22.3 ± 13.0 years were included and mean follow-up was 7.1 months.

The mean vertical deviation that APRMT corrected was 21.4 ± 3.7 PD (prism diopter).

The absolute deviation in horizontal significantly decreased from a preoperative value of 48.5 ± 27.4 PD to a value of 3.0 ± 2.3 PD 6 months postoperatively.

The movement score decreased from a value of −5 ± 0 preoperatively to a value of −2.7 ± 0.8 at 6 months postoperatively.

Conclusion.

For patients with complete vertical rectus paralysis combined with a moderate- to-large angle of horizontal strabismus, combined APRMT and partial horizontal rectus recession-resection is safe and effective for correcting vertical and horizontal strabismus.