Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy

Worawalun Honglertnapakul,1,2 Sirinuch Sawanwattanakul,1,2 Parnchat Pukrushpan,1,2 Pokpong Praneeprachachon,1–3 Supharat Jariyakosol1,2 1Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Ophthalmology Department, King Chulalongkorn Memorial Ho...

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Autores principales: Honglertnapakul W, Sawanwattanakul S, Pukrushpan P, Praneeprachachon P, Jariyakosol S
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Publicado: Dove Medical Press 2019
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spelling oai:doaj.org-article:231343adf81a4dd5b6394f4d57cde0f72021-12-02T04:18:39ZLong-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy1177-5483https://doaj.org/article/231343adf81a4dd5b6394f4d57cde0f72019-03-01T00:00:00Zhttps://www.dovepress.com/long-term-outcome-of-full-tendon-vertical-rectus-transposition-with-fo-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Worawalun Honglertnapakul,1,2 Sirinuch Sawanwattanakul,1,2 Parnchat Pukrushpan,1,2 Pokpong Praneeprachachon,1–3 Supharat Jariyakosol1,2 1Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Ophthalmology Department, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand; 3Rutnin Eye Hospital, Bangkok, Thailand Purpose: To evaluate the success rate and long-term motor and sensory outcomes of the full tendon vertical rectus transposition (VRT) with Foster suture for unilateral complete sixth cranial nerve palsy. Patients and methods: We reviewed the medical records of patients with unilateral acquired sixth cranial nerve palsy who underwent unilateral full tendon VRT with Foster suture between 2005 and 2016 and had a follow-up of ≥2 years. Data on pre- and postoperative diplopia, face turn, ocular deviation, and limitation of abduction were collected. A successful outcome was defined as a horizontal deviation ≤10 prism diopter (PD) of ortho in a primary position at distance and absence of diplopia. Results: A total of 20 patients were included in this study. Median (IQR) preoperative deviation was esotropia 65 (40–130) PD, which improved to 10 (-4 to 45) PD postoperatively. Median (IQR) improvement of esotropia was 54 (30–76) PD (P<0.001). Median (IQR) preoperative limitation of abduction was -15° (-22.5° to 10°; negative value means before reaching midline), which improved to 15° (7.5°–45°) pass midline postoperatively. Median (IQR) improvement of abduction deficit was 26° (15°–35°) (P<0.001). Successful surgical outcomes were obtained in eleven patients (55%). All patients in the non-successful group (n=9, 45%) had residual esotropia. Two of them underwent additional bilateral medial rectus recession. No postoperative vertical deviation or torsional diplopia was observed. Conclusion: In our series, the full tendon VRT with Foster suture in unilateral complete sixth cranial nerve palsy resulted in significant improvement of the ocular alignment and range of abduction over the 2-year follow-up period. Keywords: sixth cranial nerve palsy, full tendon vertical rectus transposition, Foster suture, posterior fixation suture, lateral fixation sutureHonglertnapakul WSawanwattanakul SPukrushpan PPraneeprachachon PJariyakosol SDove Medical PressarticleSixth cranial nerve palsyfull tendon vertical rectus transpositionfoster sutureposterior fixation suturelateral fixation sutureOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 515-519 (2019)
institution DOAJ
collection DOAJ
language EN
topic Sixth cranial nerve palsy
full tendon vertical rectus transposition
foster suture
posterior fixation suture
lateral fixation suture
Ophthalmology
RE1-994
spellingShingle Sixth cranial nerve palsy
full tendon vertical rectus transposition
foster suture
posterior fixation suture
lateral fixation suture
Ophthalmology
RE1-994
Honglertnapakul W
Sawanwattanakul S
Pukrushpan P
Praneeprachachon P
Jariyakosol S
Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy
description Worawalun Honglertnapakul,1,2 Sirinuch Sawanwattanakul,1,2 Parnchat Pukrushpan,1,2 Pokpong Praneeprachachon,1–3 Supharat Jariyakosol1,2 1Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 2Ophthalmology Department, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand; 3Rutnin Eye Hospital, Bangkok, Thailand Purpose: To evaluate the success rate and long-term motor and sensory outcomes of the full tendon vertical rectus transposition (VRT) with Foster suture for unilateral complete sixth cranial nerve palsy. Patients and methods: We reviewed the medical records of patients with unilateral acquired sixth cranial nerve palsy who underwent unilateral full tendon VRT with Foster suture between 2005 and 2016 and had a follow-up of ≥2 years. Data on pre- and postoperative diplopia, face turn, ocular deviation, and limitation of abduction were collected. A successful outcome was defined as a horizontal deviation ≤10 prism diopter (PD) of ortho in a primary position at distance and absence of diplopia. Results: A total of 20 patients were included in this study. Median (IQR) preoperative deviation was esotropia 65 (40–130) PD, which improved to 10 (-4 to 45) PD postoperatively. Median (IQR) improvement of esotropia was 54 (30–76) PD (P<0.001). Median (IQR) preoperative limitation of abduction was -15° (-22.5° to 10°; negative value means before reaching midline), which improved to 15° (7.5°–45°) pass midline postoperatively. Median (IQR) improvement of abduction deficit was 26° (15°–35°) (P<0.001). Successful surgical outcomes were obtained in eleven patients (55%). All patients in the non-successful group (n=9, 45%) had residual esotropia. Two of them underwent additional bilateral medial rectus recession. No postoperative vertical deviation or torsional diplopia was observed. Conclusion: In our series, the full tendon VRT with Foster suture in unilateral complete sixth cranial nerve palsy resulted in significant improvement of the ocular alignment and range of abduction over the 2-year follow-up period. Keywords: sixth cranial nerve palsy, full tendon vertical rectus transposition, Foster suture, posterior fixation suture, lateral fixation suture
format article
author Honglertnapakul W
Sawanwattanakul S
Pukrushpan P
Praneeprachachon P
Jariyakosol S
author_facet Honglertnapakul W
Sawanwattanakul S
Pukrushpan P
Praneeprachachon P
Jariyakosol S
author_sort Honglertnapakul W
title Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy
title_short Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy
title_full Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy
title_fullStr Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy
title_full_unstemmed Long-term outcome of full tendon vertical rectus transposition with Foster suture in unilateral complete sixth cranial nerve palsy
title_sort long-term outcome of full tendon vertical rectus transposition with foster suture in unilateral complete sixth cranial nerve palsy
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/231343adf81a4dd5b6394f4d57cde0f7
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