Surgical treatment for small-angle vertical strabismus

ABSTRACT

To assess the indications for and results obtained with partial vertical recti muscle recession in patients with diplopia and small-angle vertical strabismus. Retrospective study of patients who underwent partial temporal or nasal recession of the superior rectus (SR) or inferior rectus (IR). Outcome was considered favorable when diplopia had resolved in primary position and downward gaze at the end of the follow-up. A total of 17 cases were included. Mean age was 69.11 years (47% women). The diagnoses were fourth nerve paresis (6), hypertropia (3), incomplete third nerve paresis (3), sagging eye (1), age-related strabismus (1), ocular myasthenia gravis (1), and restrictive strabismus after retinal surgery (2). Mean preoperative vertical deviation was 6.11 pd in primary position, and postoperative vertical deviation was 2.05 (the mean difference was statistically significant, p < 0.001). Surgery was performed on the right eye in 29.41% of patients and on the left eye in 70.58%. The SR was treated in 11 cases (temporal pole in 7 and nasal in 4) and the IR in 6 (temporal pole in 3 and nasal in 3). Mean recession was 4.14 mm ± 0.42. Outcome was favorable in 76.47% of cases at the end of the follow-up (mean, 10 months), and the previous torsion was eliminated in 5. No overcorrections were recorded. Partial SR or IR recessions were successful in most cases of small-angle vertical strabismus. There were no overcorrections in primary position gaze.

KEYWORDS:

• Diplopia
• small-angle vertical strabismus
• partial muscular recession
• ocular torsion
• vertical recti muscle