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Vertical Tropia Following Horizontal Transposition Surgery.

A Thomas1, P Watts1

  • 1University Hospital of Wales, GB.

The British and Irish Orthoptic Journal
|July 19, 2021
PubMed
Summary
This summary is machine-generated.

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Horizontal transposition of vertical rectus muscles (HToVR) caused vertical tropia in 54% of patients with Duane syndrome or sixth nerve palsy. However, induced vertical deviations did not lead to diplopia or further surgery.

Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Neuro-ophthalmology

Background:

  • Duane syndrome and sixth nerve palsy are common conditions affecting eye movement.
  • Horizontal transposition of vertical rectus muscles (HToVR) is a surgical technique used in these conditions.
  • Understanding the potential side effects, such as vertical tropia, is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence of vertical tropia after HToVR surgery.
  • To analyze the impact of HToVR on binocular function in patients with Duane syndrome or sixth nerve palsy.

Main Methods:

  • Retrospective analysis of 11 patients with Duane syndrome or sixth nerve palsy who underwent HToVR.
  • Data collected included pre- and post-operative deviations, binocular function, and need for further surgery.
Keywords:
Duane syndromehorizontal transposition surgerysixth nerve palsyvertical tropia

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  • Botulinum toxin (BT) use and its effect on vertical deviation were also assessed.

    • Main Results:

    • 54% of patients developed post-operative vertical tropia (mean deviation 7.6^).
    • Stereoacuity improved post-operatively in most patients.
    • No patients experienced diplopia or required additional surgery for the induced vertical deviation.

    Conclusions:

    • HToVR surgery leads to a high prevalence of vertical tropia in patients with Duane syndrome or sixth nerve palsy.
    • Despite the prevalence, induced vertical deviations appear well-tolerated, without significant functional impairment or need for re-operation.