Differences in the corrective effects of vertical transposition accompanied by recession–resection of the horizontal rectus muscles for complicated vertical deviation

• Published in: Eye (London) Vol. 38; no. 17; pp. 3252 - 3257
• Main Authors: Nakao, Shin-ya, Miyata, Manabu, Yamamoto, Akinari, Kawai, Kentaro, Suda, Kenji, Nakano, Eri, Tagawa, Miho, Tsujikawa, Akitaka
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2024; Nature Publishing Group
• Subjects: 692/53/2423; 692/699/3161; Adolescent; Adult; Child; Child, Preschool; Esotropia - physiopathology; Esotropia - surgery; Exotropia - physiopathology; Exotropia - surgery; Eye Movements - physiology; Female; Follow-Up Studies; Humans; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Muscles; Oculomotor Muscles - physiopathology; Oculomotor Muscles - surgery; Ophthalmologic Surgical Procedures - methods; Ophthalmology; Patients; Pharmaceutical Sciences/Technology; Prospective Studies; Rectus muscle; Strabismus; Surgeons; Surgery; Surgical Oncology; Transposition; University graduates; Vision, Binocular - physiology; Visual Acuity - physiology; Young Adult
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-024-03270-3

Background/objectives To investigate whether the corrective effect differs between upward and downward transpositions or between exotropia and esotropia in vertical transposition accompanied by horizontal rectus muscle recession–resection. Subjects/methods This prospective study investigated 41 patients with concomitant exotropia or esotropia with small-angle vertical deviation who underwent unilateral vertical transposition accompanied by horizontal rectus muscle recession–resection and were followed up for 1 year postoperatively. We analysed the vertical deviation corrective effect, defined as the corrective amount per displacement distance (°/tendon width [TW]). We compared the corrective effects between upward and downward transpositions and between exotropia and esotropia. Additionally, we investigated the correlation between the corrective effect and the studied parameters. Results The 1-year vertical corrective effect was 5.2 ± 4.6° (9.0 ± 8.1 prism dioptres [Δ])/TW. The 1-year vertical corrective effect of upward transposition (7.9 ± 4.0° [13.8 ± 7.0Δ]/TW) was higher than that of the downward transposition (3.9 ± 4.4° [6.8 ± 7.7Δ]/TW, P  = 0.009). In contrast, upward and downward transposition did not differ between exotropia and esotropia ( P  = 0.62). Multivariate analyses revealed that the 1-year vertical corrective effect correlated with the vertical transposition direction (upward or downward) and preoperative vertical deviation but did not correlate with the disease type (exotropia or esotropia). The 1-year motor success (vertical deviation ≤ 5Δ) rate was 89%. Conclusion The vertical corrective effect of vertical transposition accompanied by horizontal rectus muscle recession–resection is greater in upward transposition than in downward transposition; however, it does not differ between exotropia and esotropia.