[Antinomic horizontal deviations: esodeviation associated with exodeviation. Clinical features and surgery].

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Binocular Vision

Context:

• Antinomic deviations present a complex challenge in strabismus management.
• These deviations involve both outward turning (exodeviation) and inward turning (esodeviation) of the eyes.
• Understanding the underlying mechanisms, such as convergence excess and fixation patterns, is crucial.

Purpose:

• To evaluate the efficacy of lateral recti recess combined with medial recti fadenoperation in treating antinomic deviations.
• To analyze different subtypes of antinomic deviations and their surgical management.
• To assess the safety and predictability of adjustable sutures in lateral recti recess for these complex cases.

Summary:

• Thirty-four patients with antinomic deviations underwent surgery involving lateral recti recess and medial recti fadenoperation.
• Four types of antinomic deviations were identified and treated.
• The study found fadenoperation on medial recti logical for convergence excess and fixation in adduction, with adjustable sutures for lateral recti recess being safer and more predictable.

Impact:

• Provides a surgical strategy for complex strabismus cases involving both exodeviation and esodeviation.
• Highlights the importance of addressing convergence excess and fixation preferences in surgical planning.
• Suggests adjustable sutures as a preferred method for lateral recti recess in challenging antinomic deviations, improving surgical outcomes.