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Torsional changes in surgery for A-V phenomena

P Sharma1, M Halder, P Prakash

  • 1Dr. R.P. Centre for Ophthalmic Sciences, AIIMS, New Delhi.

Indian Journal of Ophthalmology
|March 1, 1997
PubMed
Summary
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This study reveals that surgically induced torsion plays a key role in correcting A-V phenomena. Vertical shifting of horizontal recti muscles effectively corrects these conditions by influencing torsional eye movements.

Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Ocular Motility

Background:

  • The role of torsion in the development of A-V phenomena is often overlooked.
  • The mechanism by which vertical displacement of horizontal recti corrects A or V patterns is not fully understood, with torsional changes not adequately considered.

Purpose of the Study:

  • To evaluate the impact of vertical shifting of horizontal recti muscles on torsional changes in patients with A-V phenomena.
  • To investigate the contribution of surgically induced torsion to the correction of A-V phenomena.

Main Methods:

  • A cohort of 21 patients with A or V phenomena underwent monocular recession-resection with vertical shifting.
  • Preoperative and postoperative torsional changes were assessed using synoptophore (subjective torsion) and fundus photography (objective torsion).

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Main Results:

  • Intorsion increased post-surgery in A phenomenon cases, with 5 of 8 showing preoperative intorsion and the remaining 3 developing it postoperatively.
  • Extorsion changes were less pronounced in V phenomenon cases compared to intorsion changes in A phenomenon cases.
  • Oblique overactions were reduced in patients where they were initially present.

Conclusions:

  • Vertical shifting of horizontal recti muscles corrects A-V phenomena, likely through the induction of torsional changes.
  • Torsion is a significant, underemphasized factor in the aetiopathogenesis and surgical correction of A-V phenomena.