Horizontal muscle transposition or oblique muscle weakening for the correction of V pattern?

Şekeroğlu, Hande Taylan; Turan, Kadriye Erkan; Uzun, Şennur; Şener, Emin Cumhur; Sanaç, Ali Şefik

doi:10.1038/eye.2014.16

Cited by 8 publications

(21 citation statements)

References 11 publications

(9 reference statements)

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“…All of the patients with pattern strabismus had a V pattern. Although the reported whole prevalence of pattern deviations in strabismic patients is between 12.5% and 87.7%, about 20% of strabismic patients might be expected to have a pattern deviation [13–15]. Our result of patterns' frequency supports these previous findings.…”

Section: Discussionsupporting

confidence: 89%

Inferior Oblique Muscle Overaction: Clinical Features and Surgical Management

Özsoy

Gündüz

Öztürk

2019

Journal of Ophthalmology

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Purpose. To further define the clinical features of patients with inferior oblique muscle overaction (IOOA) and evaluate the surgical results in a subgroup of these patients. Methods. The medical records of 173 patients who underwent inferior oblique muscle (IO) weakening surgery due to primary or secondary IOOA were retrospectively reviewed. The patients were assigned a surgical group based on severity of IOOA and presence of dissociated vertical deviation (DVD) or hypertropia. Patients with +1 or +2 IOOA underwent recession, patients with +3 or +4 IOOA underwent myectomy, and patients with any grade of IOOA and DVD or hypertropia underwent anterior transposition (AT) surgery. Results. A total of 286 eyes of 173 patients who underwent surgery due to IOOA were included in the study. IOOA was accompanied by esotropia, exotropia, abnormal head posture (AHP), pattern strabismus, convergence insufficiency, DVD, facial asymmetry, and nystagmus. The most common comorbid disorder was esotropia. The recession was used in 173 eyes, myectomy in 64, and AT in 49. Surgical success was obtained in 96.0% of eyes that underwent recession, in 98.4% of eyes that underwent myectomy, and in 93.9% of eyes that underwent AT. In the follow-up, IOOA occurred in the fellow eye in 36.1% of patients who underwent unilateral surgery. Conclusions. This study is a comprehensive report on the concomitants of the IOOA. Also, it showed that all of the three surgical procedures including recession, myectomy, and AT are effective in the surgical management of IOOA when performed in select patient groups.

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Section: Discussionsupporting

confidence: 89%

Inferior Oblique Muscle Overaction: Clinical Features and Surgical Management

Özsoy

Gündüz

Öztürk

2019

Journal of Ophthalmology

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“…28 Sekeroglu et al found that half tendon width transposition of horizontal muscles significantly decreased the amount of V pattern. 29 Children with craniosynostosis often have V-pattern horizontal strabismus. 30,31 One explanation for pattern strabismus in craniosynostosis is excyclotorsion of the orbital contents, resulting in oblique pulling directions for the nominally rectus EOMs.…”

Section: Discussionmentioning

confidence: 99%

Rectus Extraocular Muscle Size and Pulley Location in Concomitant and Pattern Exotropia

Hao

Suh

et al. 2016

Ophthalmology

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Purpose To determine if rectus extraocular muscle (EOM) sizes and pulley locations contribute to exotropia, we used magnetic resonance imaging (MRI) to measure these factors in normal control subjects, and subjects with concomitant and pattern exotropia. Design Prospective, case control study. Participants Nine subjects with concomitant exotropia, 6 patients with pattern exotropia, and 21 orthotropic normal controls. Methods High-resolution, surface coil MRI was obtained in contiguous, quasi-coronal planes. Rectus pulley locations were determined in oculocentric coordinates for central gaze, supraduction, and infraduction. Cross sections in four contiguous image planes were summed and multiplied by the 2-mm slice thickness to obtain horizontal rectus posterior partial volumes (PPVs). Main outcome measures Rectus pulley locations, and horizontal rectus PPVs. Results Rectus pulleys were differently located in subjects with A, versus V and Y, pattern exotropia. The LR pulleys were significantly displaced superiorly, the MR pulleys were displaced inferiorly, and the IR pulleys were displaced laterally in A pattern exotropia. In opposite fashion, the array of all rectus pulleys was excyclorotated in V and Y pattern exotropia. The PPV of the medial rectus muscle was statistically subnormal by about 29% in concomitant but not pattern exotropia (P<0.05). The ratio of the PPV of the LR relative to the MR in concomitant exotropia was significantly greater than in normal subjects and pattern exotropia (P<0.05). Conclusions Abnormalities of EOMs and pulleys contribute differently in pattern versus concomitant exotropia. Abnormal rectus pulley locations derange EOM pulling directions that contribute to pattern exotropia, but in concomitant exotropia, pulley locations are normal and relatively small medial rectus size reduces relative adducting force.

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“…Ignoring these patterns may lead to under or over corrections, with subsequent disappointment for both patient and surgeon. 4 Around 12-87% of strabismus patients have an "A" or "V" pattern. 1,2,4 The mechanism of pattern strabismus is still unclear.…”

Section: Discussionmentioning

confidence: 99%

“…4 Around 12-87% of strabismus patients have an "A" or "V" pattern. 1,2,4 The mechanism of pattern strabismus is still unclear. Many theories have been put forward regarding its etiology.…”

Section: Discussionmentioning

confidence: 99%

Types of Pattern Strabismus and Their Surgical Outcomes after Adjustable Strabismus Surgery

Nadeem

2020

pak J Ophthalmol

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Purpose: To study the different types of pattern strabismus and their surgical outcomes after adjustable strabismus surgery. Study Design: Prospective, interventional study. Place and Duration of Study: Eye department, Fauji Foundation Hospital, Rawalpindi (June, 2016 to March, 2019). Methods: A total of 40 consecutive patients with pattern strabismus were included in the study. After complete orthoptic assessment, the patients underwent either rectus muscle transposition or oblique muscle surgery, by adjustable squint surgery. The pre-operative evaluation of different strabismus patterns, deviations, and post-operative results were measured and analyzed. The amount of postoperative pattern change was measured at 6 weeks postoperatively, to assess the success of the surgeries. Results: Out of 40 patients, 33 were females and 7 were males. The age ranged from 7 to 69 years (mean 18.05 ± 9.6). All patients were operated by using adjustable suture technique. “V” pattern was seen in 26 cases (65%) and “A” pattern was seen in 12 (30%) cases. The mean preoperative pattern was 13.2 ± 8.09 PD (prism diopters), and the mean postoperative pattern was 2.05 ± 2.96 PD. Surgical success was defined as the amount of pattern collapse at 6 weeks, the period at which a stable alignment was achieved. The difference between the preoperative and postoperative pattern deviation was statistically significant (p = 0.000). Correction of the pattern was seen in 92.5% of patients at average follow up of 50.87 ± 14.02 days. Conclusions: Pattern Strabismus can be corrected by varying rectus muscle transpositions or oblique muscle surgery during routine adjustable strabismus surgery. Key Words: Strabismus, V pattern, A pattern, Y pattern, X pattern, lambda pattern, muscle transposition.

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Horizontal muscle transposition or oblique muscle weakening for the correction of V pattern?

Cited by 8 publications

References 11 publications

Inferior Oblique Muscle Overaction: Clinical Features and Surgical Management

Inferior Oblique Muscle Overaction: Clinical Features and Surgical Management

Rectus Extraocular Muscle Size and Pulley Location in Concomitant and Pattern Exotropia

Types of Pattern Strabismus and Their Surgical Outcomes after Adjustable Strabismus Surgery

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