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Nishida procedure versus single horizontal muscle transposition in monocular elevation deficiency
Hala Elhilali1, Ahmed Awadein1, Marwa E Soliman2
1Faculty of Medicine, Cairo University, Cario, Egypt.
Summary
The Nishida procedure and single horizontal muscle upward transposition (SHMT) both effectively improve monocular elevation deficiency (MED). SHMT resulted in a slightly smaller postoperative vertical deviation, offering a comparable outcome for MED management.
Area of Science:
- Ophthalmology
- Strabismus Surgery
- Pediatric Ophthalmology
Background:
- Monocular elevation deficiency (MED) is a condition affecting eye movement.
- Surgical interventions are necessary to restore ocular motility.
Purpose of the Study:
- To compare the efficacy of the Nishida procedure and single horizontal muscle upward transposition (SHMT) in managing MED.
- To evaluate surgical outcomes, including eye movement, deviation angles, and complications.
Main Methods:
- Retrospective review of 32 patients with MED undergoing Nishida or SHMT surgery.
- Analysis of pre- and post-operative ductions, versions, fundus torsion, and deviation angles.
- Follow-up exceeding 6 months.
Main Results:
- Both procedures showed comparable improvement in elevation in adduction and abduction.
- Depression deficits occurred in 25% of the Nishida group vs. 5% of the SHMT group.
- SHMT resulted in a significantly lower mean postoperative vertical angle (0 PD vs. 3 PD).
Conclusions:
- Nishida and SHMT procedures are equally effective for improving elevation in MED.
- SHMT may offer a slight advantage with reduced postoperative vertical deviation.
