[Cyclotropia in macula translocation. Possible eye muscle surgery solutions].
BACKGROUND
Macular translocation for treatment of age-related maculopathy often necessitates surgical counter-rotation of the external eye muscles. Excyclorotatory effects can be attained generally by various surgical methods on all extraocular eye muscles. If procedures on different muscles are combined, anterior segment perfusion has to be maintained.


METHODS
The results of 29 operations were analysed in order to examine the excyclorotatory effects of 4 different combined surgical approaches.


RESULTS
In 23 patients a partial transposition of all 4 m. recti together with a high dose combined operation on both oblique muscles yielded a mean effect of 21.6 degrees excyclorotation. In four patients a vertical transposition of the horizontal m. recti in opposite directions together with a high dose combined operation on both oblique muscles led to a mean excyclorotation of 22 degrees. A full tendon transposition of the superior oblique muscle to the nasal part of the orbit in one case combined with a downward transposition of the medial rectus muscle resulted in an excyclorotation of 37 degrees, in another case combined with an anterior margin advancement of the inferior oblique muscle led to an excyclorotation of 35 degrees.


CONCLUSIONS
All approaches yielded mean counter-rotatory effects over 20 degrees. The indications are discussed under the aspects of the possibility of a one-step correction of horizontal or vertical angles, dosage, induction of inconcomitancies and operation time.
Neugebauer
A
A
Zentrum für Augenheilkunde der Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50924 Köln. Antje.Neugebauer@medizin.uni-koeln.de
Fricke
J
J
Aisenbrey
S
S
Rüssmann
W
W
D006801:Humans; D008266:Macula Lutea / Q000601:surgery*; D008268:Macular Degeneration / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D013285:Strabismus / Q000601:surgery*; D015348:Vision, Binocular