title: Management of vertical deviations after vertical rectus transposition surgery.
abstract: OBJECTIVE
  To describe options for the management of vertical deviations after vertical rectus muscle transposition surgery (VRT).
  
  
  METHODS
  Retrospective case series including 7 children who underwent VRT for esotropic Duane syndrome and developed the complication of a vertical deviation.
  
  
  RESULTS
  Eighty-two consecutive children underwent VRT for Duane syndrome. Seven eyes of 7 patients (4 boys, 3 girls) were found to have induced vertical deviations postoperatively. Average length of follow-up was 12.7 months (range, 3-28 months). Median induced vertical deviation was 10.1(Delta) (range, 8-12). All patients required only one additional surgery to ameliorate the vertical deviation. At final follow-up, the mean vertical tropic deviation was 0. Six patients were operated on within 4 days of VRT. Surgical strategies included recession of one vertical rectus muscle and repositioning of a posterior fixation suture.
  
  
  CONCLUSIONS
  In children undergoing VRT for esotropic Duane syndrome, the complication of a vertical deviation occurred in 8.5% of cases. The vertical deviation was completely ameliorated in each case by one surgical procedure involving recession of one of the transposed muscles.
authors.affiliation: Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Adrienne L
authors.initials: AL
authors.lastname: Ruth
authors.forename: Federico G
authors.initials: FG
authors.lastname: Velez
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Rosenbaum
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004370:Duane Retraction Syndrome / Q000601:surgery*; D004948:Esotropia / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies