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[Graded vertical rectus tenotomy for small angle vertical deviation].

R Hao1, L P Chen1, W Zhang1

  • 1Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin 300020, China.

[Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology
|March 14, 2022
PubMed
Summary
This summary is machine-generated.

This study shows that graded vertical rectus tenotomy effectively treats small-angle vertical deviation, significantly reducing diplopia in primary gaze. The procedure offers a reliable surgical option for strabismus patients.

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Oculomotorics

Background:

  • Small-angle vertical deviation can cause diplopia in primary gaze, impacting patient quality of life.
  • Accurate diagnosis and surgical planning are crucial for successful strabismus correction.
  • Previous surgical techniques may have limitations in addressing subtle vertical deviations.

Purpose of the Study:

  • To evaluate the efficacy of the graded vertical rectus tenotomy procedure for correcting small-angle vertical deviations.
  • To assess the impact of this surgical technique on primary gaze deviation and cyclotorsion.

Main Methods:

  • A retrospective case series of 12 patients with small-angle vertical deviation undergoing strabismus surgery.
  • Pre-operative assessment included MRI/CT scans, ocular movement examination, prism cover test, and double Maddox test.
  • Graded vertical rectus tenotomy was performed, and outcomes were measured by deviation angles at 1 day and last follow-up.

Main Results:

  • The vertical deviation angle significantly decreased from a pre-operative mean of 7.00 PD to 1.00 PD at 1 day and 1.50 PD at last follow-up (P<0.001).
  • Postoperative cyclotorsion showed no significant differences among patients.
  • Linear fitting indicated that 50%-90% vertical rectus tenotomy effectively corrected 5-8 PD of vertical deviation (R²=0.72, P<0.001).

Conclusions:

  • Graded vertical rectus tenotomy is an effective surgical method for improving small-angle vertical deviation in primary gaze.
  • The procedure demonstrates a strong correlation between the extent of tenotomy and the degree of vertical deviation corrected.
  • This technique offers a predictable and successful approach for managing specific types of strabismus.