Sliding shape extraocular muscle transposition with plication: Long-term results

This study aims to evaluate the long-term results of sliding shape extraocular muscle transposition, which is a novel operation method of delivering both vascular protection and strengthening of the muscles and transposition of the muscles.

The patients' files were scanned retrospectively. All patients underwent a complete eye examination in addition to motility examination, both preoperatively and postoperatively. Patients were followed up for at least 1 year. Pre- and postoperative deviation measurement values and transposition effects were compared statistically. The two parameters were evaluated separately.

In patients where 7-mm (or greater) resection was planned, the complete muscle widening transposition procedure was successful. Only two-thirds of transpositions could be achieved in patients who underwent less than 7 mm of strengthening. There was no anterior segment ischemia in the patients who underwent three rectus' muscle surgery in the same eye. Transposition effects were perfect in those whose vertical deviation was not due to monocular elevation deficiency. While resection effect was excellent in those MED (monocular elevation deficiency) and CEOMF (congenital extraocular muscle fibrosis) cases, transposition effects were limited but found at similar rates as with the standard resection and transposition procedures in CCDD (congenital cranial dis-innervation diseases) (R2-1).

Even transposition effects were limited in CCDD. 'Sliding shape' design extraocular muscle plication was found to be a simple, safe, and effective procedure for patients who needed resection and transposition operation.