title: Results of compensatory extraocular muscle surgery after macular translocation.
abstract: OBJECTIVE
  Macular translocation is an optional surgical treatment for age-related macular degeneration. However, this technique induces postoperative torsional complaints and surgical counterrotation of the globe is mandatory. The purpose of this study is to report the effect of compensatory extraocular muscle surgery upon the torsional complaints in patients who underwent a macular translocation procedure.
  
  
  METHODS
  The pre- and postoperative data on the first 35 patients in our department who underwent a counterrotation procedure after macular translocation surgery are reviewed.
  
  
  METHODS
  From November 2001 to January 2005, 35 patients underwent a macular translocation procedure, with subsequent extraocular muscle surgery to counterrotate the eye. Three types of rectus muscle transposition procedures were used: full-tendon transposition of two opposite rectus muscles, "crossed" half-tendon transposition of all rectus muscles ('split & cross' procedure), and "uncrossed" half-tendon transposition of all rectus muscles ('split & neighbor cross' procedure). In the majority of patients these procedures were associated with oblique muscle surgery.
  
  
  RESULTS
  With the selected procedures, retinal excyclodeviations are easier to correct then retinal incyclodeviations. In our hands, full-tendon transposition of two opposite rectus muscles with or without associated oblique muscle surgery, never corrects more than 30 degrees. 'Split & cross' procedures combined with oblique muscle surgery are sufficient for retinal excyclodeviations of 30-45 degrees and for incyclodeviations of up to 30 degrees; 'split & neighbor cross' procedures combined with oblique muscle surgery are sufficient for retinal excyclodeviations of 45-65 degrees and for incyclodeviations of up to 40 degrees .
  
  
  CONCLUSIONS
  The effect of the various procedures appears to be predictable. It is possible to select a surgical procedure as a function of the amount of retinal cyclodeviation.
authors.affiliation: Department of Ophthalmology, Catholic University of Louvain, Louvain, Belgium. declippeleir@uz.kuleuven.ac.be
authors.forename: Lucie
authors.initials: L
authors.lastname: De Clippeleir
authors.forename: Peter
authors.initials: P
authors.lastname: Stalmans
authors.forename: May
authors.initials: M
authors.lastname: Dieltiëns
authors.forename: Louise
authors.initials: L
authors.lastname: Baekeland
authors.forename: Liesbet
authors.initials: L
authors.lastname: Beelen
authors.forename: Hilde
authors.initials: H
authors.lastname: Janssens
authors.forename: Mirjam
authors.initials: M
authors.lastname: van Lammeren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004172:Diplopia / Q000209:etiology / Q000601:surgery; D006801:Humans; D008268:Macular Degeneration / Q000601:surgery*; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D012160:Retina / Q000637:transplantation*; D013285:Strabismus / Q000209:etiology / Q000601:surgery; D013709:Tendon Transfer; D016896:Treatment Outcome