Treatment for A and V strabismus by slanting muscle insertions.
OBJECTIVE
To evaluate the therapeutic effects of surgically slanting extraocular muscle insertions.


METHODS
Observational case series.


METHODS
We performed slanting recession and resection on medial or lateral rectus muscles. We created a slanting surgical reinsertion line with a 3-4 mm difference between upper and lower corners of the muscles, in 31 patients with A or V strabismus (V exotropia in 16 patients; A exotropia in 12; A esotropia in 3). Cases with V exotropia with moderate or marked overaction of inferior oblique muscle were excluded.


RESULTS
V exotropia: The average amount of V pattern was 17.9 PD before and 7.6 PD after surgery. Slanting surgery reduced the V pattern in 15 of 16 patients. The mean amount of reduction was 10.3 PD in the V pattern and 29.8 PD in upgaze. A exotropia: The average amount of the A pattern was 26.6 PD before and 6.3 PD after surgery. Slanting surgery reduced the A pattern in 8 of 12 patients. The mean reduction was 20.3 PD in the A pattern and 36.4 PD in downgaze. A esotropia: The average amount of the A pattern was 23 PD before and 8 PD after surgery, reducing the A pattern in 1 of 3 patients.


CONCLUSIONS
The surgical technique of slanting muscle insertions for correction of A and V strabismus is a suitable procedure for reducing or eliminating A and V patterns.
Ohba
Masahiro
M
Department of Ophthalmology, Sapporo Medical University School of Medicine, S-1 W-16, Chuo-ku, Sapporo 060-8543, Japan. ohba@sapmed.ac.jp
Ohtsuka
Kenji
K
Osanai
Hajime
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D013285:Strabismus / Q000601:surgery*; D015348:Vision, Binocular