Transposition of the anterior superior oblique insertion as a treatment for excyclotorsion induced from limited macular translocation.
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.
Ohtsuki
Hiroshi
H
Department of Ophthalmology, Okayama University, Graduate School of Medicine and Dentistry, Japan. opth@cc.okayama-u.ac.jp
Shiraga
Fumio
F
Morizane
Yuuki
Y
Furuse
Takashi
T
Takasu
Ippei
I
Hasebe
Satoshi
S
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