title: Transposition of the anterior superior oblique insertion as a treatment for excyclotorsion induced from limited macular translocation.
abstract: OBJECTIVE
  To evaluate the transposition of the anterior superior oblique insertion as a treatment for cyclovertical diplopia accompanied by an awareness of tilted image perceived with the affected eye induced from limited macular translocation (LMT).
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Transposition of the anterior part of the superior oblique tendon combined with or without vertical muscle surgery on the affected eye was retrospectively studied in seven patients. Clinical outcome was assessed for binocular and monocular vision. A successful result was defined as restoration of single binocular vision (SBV) at distance and near examined with the Bagolini test with disappearance of a tilted image perceived in the affected eye.
  
  
  RESULTS
  Six of seven patients (86%) became unaware of tilted image, and three patients (43%) obtained successful results after the strabismus surgery. Of these three patients with successful results, one (33%) patient recognized metamorphopsia, whereas two (67%) of the three patients with unfavorable results reported metamorphopsia. Patients with successful results showed a visual acuity of 20/25 or better in the affected eye and a significantly smaller difference in visual acuity between the two eyes than those patients with unfavorable surgical results (0.133 logarithm of the minimal angle of resolution for SBV(+) vs 0.675 logarithm of the minimal angle of resolution for SBV(-); P =.0255).
  
  
  CONCLUSIONS
  The relatively low success for restoration of SBV indicates that strabismus surgery is recommended for patients whose difference in visual acuity between the two eyes is small and who have a high level visual acuity of the affected eye.
authors.affiliation: Department of Ophthalmology, Okayama University, Graduate School of Medicine and Dentistry, Japan. opth@cc.okayama-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtsuki
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Morizane
authors.forename: Takashi
authors.initials: T
authors.lastname: Furuse
authors.forename: Ippei
authors.initials: I
authors.lastname: Takasu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hasebe
mesh_terms: D000328:Adult; D000368:Aged; D020256:Choroidal Neovascularization / Q000601:surgery; D004172:Diplopia / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000637:transplantation*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013285:Strabismus / Q000209:etiology / Q000601:surgery*; D013709:Tendon Transfer; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields