title: Torsion and pattern strabismus: potential conflicts in treatment.
abstract: OBJECTIVE
  Rectus muscle transposition to treat pattern strabismus or torsion may have an adverse outcome if the surgeon is unaware that it will affect both pattern strabismus and torsion in contradictory ways.
  
  
  OBJECTIVE
  To highlight the potential adverse affects of rectus muscle transposition on torsion or pattern strabismus.
  
  
  METHODS
  A retrospective nonblinded medical record review of patients treated by the author between January 1, 1990, and June 30, 2009, in whom rectus muscle transposition to address pattern strabismus worsened torsion, or in whom transposition to address torsion worsened pattern strabismus. The main outcome was a worsening of either torsion or pattern strabismus.
  
  
  METHODS
  A tertiary care university referral center.
  
  
  METHODS
  Rectus muscle transposition surgery to either treat pattern strabismus or torsion.
  
  
  METHODS
  The presence of new or worsened pattern strabismus or torsion. The outcome measures were determined before data collection began.
  
  
  RESULTS
  Eight patients were identified by the review, 5 in whom torsion developed because of transposition to address pattern strabismus and 3 in whom pattern strabismus developed after transposition to address torsion. The presence of bifoveal fusion and/or Graves orbitopathy were risk factors for these adverse outcomes.
  
  
  CONCLUSIONS
  Rectus muscle transposition to address pattern strabismus may cause torsion, and transposition to address torsion may cause pattern strabismus.
authors: Section of Pediatric Ophthalmology and Adult Strabismus, Department of Ophthalmology and Visual Sciences, University of Wisconsin, 2870 University Ave, Ste 206, Madison, WI 53705, USA. bkushner@wisc.edu
authors: Burton J
authors: BJ
authors: Kushner
mesh_terms: D004172:Diplopia / Q000601:surgery; D005260:Female; D049970:Graves Ophthalmopathy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*; D014102:Torsion Abnormality / Q000209:etiology* / Q000503:physiopathology