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

作　　者：Ortal Fogel-Tempelhof Anat Bachar Zipori Chaim Stolovitch Oriel Spierer 

机构地区：[1]Department of Ophthalmology,Tel Aviv Sourasky Medical Center,Affiliated to the Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv 6423906,Israel [2]Pediatric Ophthalmology and Strabismus Unit,E.Wolfson Medical Center,Affiliated to the Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv 6423906,Israel

出　　处：《International Journal of Ophthalmology(English edition)》2021年第12期1921-1927,共7页国际眼科杂志（英文版）

摘　　要：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.

关 键 词：vertical rectus muscles transposition sixth nerve palsy abducens nerve palsy ESOTROPIA strabismus surgery 

分 类 号：R779.6[医药卫生—眼科]