Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy

AIM: To describe the experience with half-width vertical muscles transposition (VRT) augmented with posterior fixation sutures. METHODS: The clinical charts of all patients, who underwent half-width VRT augmented with posterior fixation sutures for sixth cranial nerve palsy from January 2003 to Dece...

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Autores principales:	Ortal Fogel-Tempelhof, Anat Bachar Zipori, Chaim Stolovitch, Oriel Spierer
Formato:	article
Lenguaje:	EN
Publicado:	Press of International Journal of Ophthalmology (IJO PRESS) 2021
Materias:	vertical rectus muscles transposition sixth nerve palsy abducens nerve palsy esotropia strabismus surgery Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2f499757099e4f3c9ed0cbba1592957c
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spelling	oai:doaj.org-article:2f499757099e4f3c9ed0cbba1592957c2021-11-26T04:02:12ZOutcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy2222-39592227-489810.18240/ijo.2021.12.17https://doaj.org/article/2f499757099e4f3c9ed0cbba1592957c2021-12-01T00:00:00Zhttp://ies.ijo.cn/en_publish/2021/12/20211217.pdfhttps://doaj.org/toc/2222-3959https://doaj.org/toc/2227-4898AIM: To describe the experience with half-width vertical muscles transposition (VRT) augmented with posterior fixation sutures. METHODS: The clinical charts of all patients, who underwent half-width VRT augmented with posterior fixation sutures for sixth cranial nerve palsy from January 2003 to December 2018, were retrospectively reviewed. For each patient, pre- and post-operatively, the largest measured angle was used for the calculations, usually resulting with the angle for distance, except in young infants, where measurements were made at near fixation using the Krimsky test. RESULTS: Fifteen patients met the inclusion criteria for the study, of them 9 (60.0%) had also medial rectus muscle recession at the time of surgery. Mean follow-up period was 21.4±23.2mo (range 1.5-82mo). Preoperative mean esotropia was 51.3±19.7 prism diopter (PD; range 20-90 PD). Postoperative mean deviation on final follow-up was 7.7±20.2 PD (range -40 to 35 PD; P=0.018). In all patients with preoperative abnormal head position, improvement was noted. Ten (66.7%) patients had improvement in abduction and 10 (66.7%) patients reported improvement in their diplopia, by final follow-up. The addition of medial rectus recession was correlated with a larger change in postoperative horizontal deviation compared to baseline (P=0.026). Two (13.3%) patients developed a vertical deviation in the immediate postoperative period which had resolved in one of them. CONCLUSION: Half-width VRT augmented with posterior fixation suture, with or without medial rectus muscle recession, is an effective and safe procedure for esotropia associated with sixth cranial nerve palsy. A major improvement in the angle of deviation is expected. Most patients will have improvement in their abnormal head position and diplopia.Ortal Fogel-TempelhofAnat Bachar ZiporiChaim StolovitchOriel SpiererPress of International Journal of Ophthalmology (IJO PRESS)articlevertical rectus muscles transpositionsixth nerve palsyabducens nerve palsyesotropiastrabismus surgeryOphthalmologyRE1-994ENInternational Journal of Ophthalmology, Vol 14, Iss 12, Pp 1921-1927 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	vertical rectus muscles transposition sixth nerve palsy abducens nerve palsy esotropia strabismus surgery Ophthalmology RE1-994
spellingShingle	vertical rectus muscles transposition sixth nerve palsy abducens nerve palsy esotropia strabismus surgery Ophthalmology RE1-994 Ortal Fogel-Tempelhof Anat Bachar Zipori Chaim Stolovitch Oriel Spierer Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
description	AIM: To describe the experience with half-width vertical muscles transposition (VRT) augmented with posterior fixation sutures. METHODS: The clinical charts of all patients, who underwent half-width VRT augmented with posterior fixation sutures for sixth cranial nerve palsy from January 2003 to December 2018, were retrospectively reviewed. For each patient, pre- and post-operatively, the largest measured angle was used for the calculations, usually resulting with the angle for distance, except in young infants, where measurements were made at near fixation using the Krimsky test. RESULTS: Fifteen patients met the inclusion criteria for the study, of them 9 (60.0%) had also medial rectus muscle recession at the time of surgery. Mean follow-up period was 21.4±23.2mo (range 1.5-82mo). Preoperative mean esotropia was 51.3±19.7 prism diopter (PD; range 20-90 PD). Postoperative mean deviation on final follow-up was 7.7±20.2 PD (range -40 to 35 PD; P=0.018). In all patients with preoperative abnormal head position, improvement was noted. Ten (66.7%) patients had improvement in abduction and 10 (66.7%) patients reported improvement in their diplopia, by final follow-up. The addition of medial rectus recession was correlated with a larger change in postoperative horizontal deviation compared to baseline (P=0.026). Two (13.3%) patients developed a vertical deviation in the immediate postoperative period which had resolved in one of them. CONCLUSION: Half-width VRT augmented with posterior fixation suture, with or without medial rectus muscle recession, is an effective and safe procedure for esotropia associated with sixth cranial nerve palsy. A major improvement in the angle of deviation is expected. Most patients will have improvement in their abnormal head position and diplopia.
format	article
author	Ortal Fogel-Tempelhof Anat Bachar Zipori Chaim Stolovitch Oriel Spierer
author_facet	Ortal Fogel-Tempelhof Anat Bachar Zipori Chaim Stolovitch Oriel Spierer
author_sort	Ortal Fogel-Tempelhof
title	Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
title_short	Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
title_full	Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
title_fullStr	Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
title_full_unstemmed	Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
title_sort	outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy
publisher	Press of International Journal of Ophthalmology (IJO PRESS)
publishDate	2021
url	https://doaj.org/article/2f499757099e4f3c9ed0cbba1592957c
work_keys_str_mv	AT ortalfogeltempelhof outcomesofhalfwidthverticalrectustranspositionaugmentedwithposteriorfixationsuturesforsixthcranialnervepalsy AT anatbacharzipori outcomesofhalfwidthverticalrectustranspositionaugmentedwithposteriorfixationsuturesforsixthcranialnervepalsy AT chaimstolovitch outcomesofhalfwidthverticalrectustranspositionaugmentedwithposteriorfixationsuturesforsixthcranialnervepalsy AT orielspierer outcomesofhalfwidthverticalrectustranspositionaugmentedwithposteriorfixationsuturesforsixthcranialnervepalsy
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Outcomes of half-width vertical rectus transposition augmented with posterior fixation sutures for sixth cranial nerve palsy

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