title: Surgical outcome in monocular elevation deficit: a retrospective interventional study.
abstract: OBJECTIVE
  Monocular elevation deficiency (MED) is characterized by a unilateral defect in elevation, caused by paretic, restrictive or combined etiology. Treatment of this multifactorial entity is therefore varied. In this study, we performed different surgical procedures in patients of MED and evaluated their outcome, based on ocular alignment, improvement in elevation and binocular functions.
  
  
  METHODS
  Retrospective interventional study.
  
  
  METHODS
  Twenty-eight patients were included in this study, from June 2003 to August 2006. Five patients underwent Knapp procedure, with or without horizontal squint surgery, 17 patients had inferior rectus recession, with or without horizontal squint surgery, three patients had combined inferior rectus recession and Knapp procedure and three patients had inferior rectus recession combined with contralateral superior rectus or inferior oblique surgery. The choice of procedure was based on the results of forced duction test (FDT).
  
  
  RESULTS
  Forced duction test was positive in 23 cases (82%). Twenty-four of 28 patients (86%) were aligned to within 10 prism diopters. Elevation improved in 10 patients (36%) from no elevation above primary position (-4) to only slight limitation of elevation (-1). Five patients had preoperative binocular vision and none gained it postoperatively. No significant postoperative complications or duction abnormalities were observed during the follow-up period.
  
  
  CONCLUSIONS
  Management of MED depends upon selection of the correct surgical technique based on employing the results of FDT, for a satisfactory outcome.
authors.affiliation: Pediatric Ophthalmology and Strabismus Department, Aravind Eye Hospital, Madurai - 625 020, Tamil Nadu, India.
authors.forename: Rakhi
authors.initials: R
authors.lastname: Bandyopadhyay
authors.forename: Shashikant
authors.initials: S
authors.lastname: Shetty
authors.forename: P
authors.initials: P
authors.lastname: Vijayalakshmi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000503:physiopathology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D015349:Vision, Monocular; D055815:Young Adult