Results with graduated recession of the superior oblique muscle

A technique for graduated recession of the superior oblique muscle is described and the results in 22 patients outlined. For each dioptre of vertical error 1 mm of recession was performed with a minimum of 5 and maximum of 10mm. A good result reducing the vertical deviation to less than 3 dioptres was obtained in 9 of 21 cases. A good result was much more likely with an initial vertical deviation of 4 - 10 dioptres and if only one superior oblique was operated upon. A good result with elimination of the A sign was obtained in 13 of 15 cases with either unilateral or bilateral surgery. Graduated recession seems safe and predictable and is capable of being combined with other squint surgery.