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Treatment for A and V strabismus by slanting muscle insertions
Masahiro Ohba1, Kenji Ohtsuka, Hajime Osanai
1Department of Ophthalmology, Sapporo Medical University School of Medicine, S-1 W-16, Chuo-ku, Sapporo 060-8543, Japan. ohba@sapmed.ac.jp
Purpose:
To evaluate the therapeutic effects of surgically slanting extraocular muscle insertions.
Research Design:
Observational case series.
Methods:
We performed slanting recession and resection on medial or lateral rectus muscles. We created a slanting surgical reinsertion line with a 3-4 mm difference between upper and lower corners of the muscles, in 31 patients with A or V strabismus (V exotropia in 16 patients; A exotropia in 12; A esotropia in 3). Cases with V exotropia with moderate or marked overaction of inferior oblique muscle were excluded.
Results:
V exotropia: The average amount of V pattern was 17.9 PD before and 7.6 PD after surgery. Slanting surgery reduced the V pattern in 15 of 16 patients. The mean amount of reduction was 10.3 PD in the V pattern and 29.8 PD in upgaze. A exotropia: The average amount of the A pattern was 26.6 PD before and 6.3 PD after surgery. Slanting surgery reduced the A pattern in 8 of 12 patients. The mean reduction was 20.3 PD in the A pattern and 36.4 PD in downgaze. A esotropia: The average amount of the A pattern was 23 PD before and 8 PD after surgery, reducing the A pattern in 1 of 3 patients.
Conclusion:
The surgical technique of slanting muscle insertions for correction of A and V strabismus is a suitable procedure for reducing or eliminating A and V patterns.