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Effect of vertical transposition of the medial rectus muscle on primary position alignment in infantile esotropia with A- or V-pattern strabismus.
MedLine Citation:
PMID:  21397800     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To determine the effect of vertical displacement of muscle insertions on the surgical dose-response relationship in patients undergoing bilateral medial rectus recessions.
METHODS: Retrospective chart review of patients undergoing bilateral medial rectus recessions for correction of congenital esotropia with or without vertical displacement for A or V patterns. Patients were clustered into A pattern, V pattern, and "simple" (no pattern) groups. Strabismus angle at distance and near before and after surgery was recorded. Surgical dose-response relationships (in prism diopters/mm) were determined at the 6-month follow-up visit and compared.
RESULTS: A total of 55 patients (28 male and 27 female patients; mean age, 6.9 years; range, 2-17 years) were included. Of these, 28 had either A pattern (18) or V pattern (10), and 27 were in the simple group. Mean preoperative angle of deviation was 34(Δ) at distance and 40(Δ) at near. The surgical dose-response relationship was significantly greater (at both distance and near) in the A pattern group (2.43(Δ)/mm, distance [p = 0.005]; 2.76(Δ)/mm, near [p = 0.04]) than in the simple group (1.56(Δ)/mm, distance; 2.03(Δ)/mm, near). The surgical response in the V pattern group (1.96(Δ)/mm, distance [p = 0.34]; 2.03(Δ)/mm, near [p = 0.94]) was not significantly different from the simple group.
CONCLUSIONS: Upward displacement of the medial rectus muscles increased the surgical dose/response relationship in patients with A-pattern esotropia. A similar effect was not observed with downward displacement in patients with V-pattern strabismus. Surgeons should be aware of this enhanced response when planning surgery for A-pattern esotropia.
Authors:
Anna Dickmann; Sergio Petroni; Annabella Salerni; Rosa Parrilla; Gustavo Savino; Remo Battendieri; Vittoria Perrotta; Cecilia Radini; Emilio Balestrazzi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus     Volume:  15     ISSN:  1528-3933     ISO Abbreviation:  J AAPOS     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-03-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9710011     Medline TA:  J AAPOS     Country:  United States    
Other Details:
Languages:  eng     Pagination:  14-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Affiliation:
Institute of Ophthalmology, Catholic University of Rome, Rome, Italy.
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