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[Antinomic horizontal deviations: esodeviation associated with exodeviation. Clinical features and surgery]
1Cabinet d'Ophtalmologie, 11, rue de la Ravinelle, 54000 Nancy.
Introduction:
Antinomic deviations are defined as a basic exoposition of the eyes associated with innervational convergence excess leading to an esoposition.
Patients And Methods:
Thirty-four patients with both exodeviation and esodeviation were studied. Surgery consisted in lateral recti (LR) recess with fadenoperation on the medial recti.
Results:
Four types of antinomic deviations were found: 1- Primitive exodeviation with an excess of physiological accommodative vergences; 2- Consecutive exodeviation due to surgical overcorrection of an accommodative esotropia; 3- Infantile exodeviation with fixation in adduction, DHD +/- convergence excess; 4- Consecutive infantile exodeviation: overcorrection of a congenital esotropia.
Conclusion:
Although fadenoperation on the medial recti may seem paradoxical in exodeviations, it is the most logical procedure to deal with convergence excess and fixation in adduction prevalence. Adjustable sutures for the lateral recti recess appear safer and more predictible in these difficult cases.
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