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Related Experiment Videos

Simultaneous 4-muscle surgery in V-esotropia

M Romem, Z Gasul

    Journal of Pediatric Ophthalmology and Strabismus
    |January 1, 1978
    PubMed
    Summary

    Simultaneous surgery for V-esotropia in 60 patients yielded good results in 80%. Adding inferior oblique weakening to medial rectus recession improved outcomes, suggesting 4-muscle surgery for specific V-esotropia cases.

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    Area of Science:

    • Ophthalmology
    • Strabismus Surgery
    • Pediatric Ophthalmology

    Background:

    • V-esotropia is a complex strabismus characterized by a V-pattern deviation.
    • Surgical management aims to correct the horizontal and vertical deviations.
    • Inferior oblique overaction is often associated with V-esotropia.

    Purpose of the Study:

    • To evaluate the efficacy of simultaneous, bilateral, and symmetrical surgery for V-esotropia.
    • To compare outcomes of medial rectus recession with and without inferior oblique weakening.
    • To determine the optimal surgical approach for V-esotropia with inferior oblique overaction.

    Main Methods:

    • A cohort of 60 patients with V-esotropia underwent simultaneous, bilateral, and symmetrical surgery.
    • Patients were divided into three groups: bilateral medial rectus recession alone, or combined with inferior oblique recession or myectomy.
    • Surgical outcomes were assessed after one procedure.

    Main Results:

    • Satisfactory results were achieved in 48 out of 60 patients (80%) after a single surgery.
    • Consecutive esotropia occurred in 8 patients, and exotropia in 4 patients.
    • Simultaneous 4-muscle surgery (medial recti and inferior obliques) showed promising results.

    Conclusions:

    • Simultaneous, bilateral, and symmetrical surgery is effective for V-esotropia.
    • Weakening the inferior obliques in addition to horizontal muscle surgery is recommended for V-esotropia with significant inferior oblique overaction.
    • A 4-muscle surgical approach may minimize the need for reoperations.

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