Department of Ophthalmology, Charité - University Medicine Berlin, Berlin, Germany.
Eur J Ophthalmol. 2021 May;31(3):1333-1337. doi: 10.1177/1120672120934979. Epub 2020 Jun 19.
To study the effect of vertically transposing both horizontal eye muscles of one eye in the same direction on vertical strabismus.
Retrospective analysis of 33 patients in whom vertical transposition of the medial and lateral rectus muscles was combined with a recession/resection or recession/plication procedure. Preoperative ocular alignment was compared with that 1 day and 3 months postoperatively.
Mean preoperative vertical deviation was 7.8 ± 4.3 (median 7.5, range 3-25) prism diopters (PD) at distance and 7.8 ± 4.1 (7, 0-18) PD at near. Vertical transposition of the horizontal rectus muscles averaged 5.6 ± 1.6 mm and reduced the vertical deviation to 3.4 ± 4.2 PD (2, 0-16) at distance and 2.9 ± 3.7 PD (2, 0-14) at near. Mean effect on the vertical deviation was 0.9 ± 0.7 (0.8, -0.8 to 2.13) PD/mm at distance and 0.9 ± 0.9 (0.83, -1 to 3) PD/mm at near, it was similar in patients operated on for esotropia and for exotropia. The surgical effect on the horizontal deviation was 2.1 ± 1.1 PD/mm (distance) and 2.6 ± 1 PD/mm (near). Both the vertical and horizontal surgical dose correlated with the effect in a linear way, but the variability was greater for the vertical transposition.
Vertical transposition of the horizontal rectus muscles in the same direction allows for correction of vertical strabismus. This procedure may be performed during primarily horizontal strabismus surgery, without operating on an additional extraocular muscle. The transposition distance correlates with the surgical effect but predictability of the effect is limited.
研究同一眼的水平直肌垂直同向转位对垂直斜视的影响。
对 33 例接受内直肌和外直肌垂直转位联合后退/截除或后退/缩短术的患者进行回顾性分析。比较术前、术后 1 天和 3 个月的眼球眼位。
平均术前垂直偏斜距离为 7.8 ± 4.3（中位数 7.5，范围 3-25）棱镜度，近距为 7.8 ± 4.1（7，0-18）棱镜度。水平直肌垂直转位平均 5.6 ± 1.6 mm，使垂直偏斜距离减小至 3.4 ± 4.2 PD（2，0-16），近距为 2.9 ± 3.7 PD（2，0-14）。距离上平均垂直偏斜改变量为 0.9 ± 0.7（0.8，-0.8 至 2.13）PD/mm，近距为 0.9 ± 0.9（0.83，-1 至 3）PD/mm，内斜视和外斜视患者的手术效果相似。水平偏差的手术效果为 2.1 ± 1.1 PD/mm（距离）和 2.6 ± 1 PD/mm（近距）。垂直和水平手术剂量均与效果呈线性相关，但垂直转位的变异性更大。
同一方向的水平直肌垂直转位可矫正垂直斜视。该手术可在主要进行水平斜视手术时进行，无需额外行眼外肌手术。转位距离与手术效果相关，但效果的可预测性有限。
