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Inferior Rectus Transposition: A Novel Procedure for Abducens Palsy
Federico G Velez1, Melinda Y Chang1, Stacy L Pineles1
1Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California.
American Journal of Ophthalmology
|March 4, 2017
Summary
Inferior rectus transposition (IRT) surgery significantly improved ocular alignment and reduced head tilting in patients with abducens palsy. This procedure may benefit those with specific preoperative conditions, showing promising outcomes.
Area of Science:
- Ophthalmology
- Strabismus Surgery
Background:
- Superior rectus transposition is a common treatment for abduction deficiencies but can cause vertical deviation or torsion.
- Inferior rectus transposition (IRT) presents an alternative for patients at risk of these complications.
Purpose of the Study:
- To evaluate the outcomes of patients who underwent inferior rectus transposition (IRT) for strabismus.
Main Methods:
- A prospective interventional case series was conducted on five patients with complete lateral rectus palsy who underwent IRT.
- Preoperative and postoperative measurements of head posture, ocular rotations, alignment, and torsion were compared.
Main Results:
- Significant improvement in esotropia (from 39±17Δ to 12±9.8Δ) and torticollis (from 31.4±11.6° to 5±5.8°) was observed.
- Abduction improved in all patients, and IRT showed a downward shifting effect in patients with preoperative hypertropia.
Conclusions:
- Inferior rectus transposition (IRT) demonstrates significant improvement in ocular alignment and torticollis in patients with abducens palsy.
- IRT may be a beneficial alternative for patients with preoperative hypertropia or intorsion, though further research is needed.
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